Organization
NORTHWEST INFECTIOUS DISEASE AND TRAVEL MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PORNTHEP WATTANAMANO M.D. (PRESIDENT)
(713) 384-3229
Entity
Organization
Contact information
Practice address
5509 CORNISH ST., HOUSTON, TX 77007-4303
(713) 831-5089
(713) 360-7715
Mailing address
5509 CORNISH ST., HOUSTON, TX 77007-4303
(713) 831-5089
(713) 360-7715
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171630001
—
TX
Enumeration date
06/13/2005
Last updated
07/21/2022
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