Provider Demographics
NPI:1306957923
Name:AMBANI, DIPIKA S (MD, FACOG)
Entity type:Individual
Prefix:
First Name:DIPIKA
Middle Name:S
Last Name:AMBANI
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 FANNIN ST STE 840
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1934
Mailing Address - Country:US
Mailing Address - Phone:713-272-7600
Mailing Address - Fax:713-272-7650
Practice Address - Street 1:7400 FANNIN ST STE 840
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1934
Practice Address - Country:US
Practice Address - Phone:713-272-7600
Practice Address - Fax:713-272-7650
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3857207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183167902Medicaid
TX189798501Medicaid
TX183167902Medicaid
TX189798501Medicaid
TX00Y362Medicare PIN