Provider Demographics
NPI:1427132760
Name:KHAMAPIRAD, TUENCHIT (MD)
Entity type:Individual
Prefix:
First Name:TUENCHIT
Middle Name:
Last Name:KHAMAPIRAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 749
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-7465
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 749
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-7465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE64522085R0202X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101569503Medicaid
TX101569504Medicaid
TX8BQ330OtherBCBS
TX101569504Medicaid
TX300099168Medicare PIN
TX8BQ330OtherBCBS
TXCI5830Medicare PIN
TX101569504Medicaid
8K9800Medicare PIN
TXB23923Medicare UPIN
TX00R518Medicare PIN
TX8F21044Medicare PIN