Individual
EMMA CID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2262 BANCROFT ST, HOUSTON, TX 77027-3706
(713) 208-4888
(713) 391-8425
Mailing address
2262 BANCROFT ST, HOUSTON, TX 77027-3706
(713) 208-4888
(713) 391-8425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J2541
TX
207RC0000X
Cardiovascular Disease Physician
Primary
J2541
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134709803
—
TX
Enumeration date
07/10/2006
Last updated
05/16/2012
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