Provider Demographics
NPI:1962529115
Name:SEVAK OHANIAN MD PA
Entity type:Organization
Organization Name:SEVAK OHANIAN MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-461-7878
Mailing Address - Street 1:411 PARK GROVE LN STE 510
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1575
Mailing Address - Country:US
Mailing Address - Phone:713-461-7878
Mailing Address - Fax:713-461-7877
Practice Address - Street 1:411 PARK GROVE LN STE 510
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1575
Practice Address - Country:US
Practice Address - Phone:713-461-7878
Practice Address - Fax:713-461-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK56452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182267801Medicaid
TX0047MYOtherBCBS
TX182267801Medicaid