Provider Demographics
NPI:1124287081
Name:VERMA, NAMITA (DO)
Entity type:Individual
Prefix:
First Name:NAMITA
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BLALOCK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6473
Mailing Address - Country:US
Mailing Address - Phone:713-781-0844
Mailing Address - Fax:713-781-1350
Practice Address - Street 1:1220 BLALOCK RD
Practice Address - Street 2:SUITE 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6472
Practice Address - Country:US
Practice Address - Phone:713-781-0844
Practice Address - Fax:713-781-1350
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1502207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1124287081OtherNPI NUMBER
TX207Q00000XOtherTAXONOMY
TX350445802Medicaid
TX003AAXOtherBCBS OF TEXAS
TXTXB155791Medicare UPIN
TX503055Medicare PIN