Provider Demographics
NPI:1992810147
Name:WATCHA, MEHERNOOR (MD)
Entity type:Individual
Prefix:
First Name:MEHERNOOR
Middle Name:
Last Name:WATCHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREENWAY PLZ
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0297
Mailing Address - Country:US
Mailing Address - Phone:832-824-5800
Mailing Address - Fax:832-825-5801
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:SUITE A 3300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-824-5800
Practice Address - Fax:832-825-5801
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023445E207L00000X, 207L00000X, 208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016877430Medicaid
PAA12172Medicare UPIN
PA005647Medicare ID - Type Unspecified