Fancimol Pallathumadom, BSN, MBA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

712785 Issued in TX

Practice address

9000 Southwest Fwy Ste 200
Houston, TX 77074-1529

Phone

(832) 400-2333

NPI assigned

Jan 19, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Master of Business Administration

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alaine Diagnostic LLC

  • Clinical Medical Laboratory
  • Houston, TX
  • NPI 1104454651
  NPD
• Alaine Diagnostic of NJ LLC

  • Clinical Medical Laboratory
  • Saddle Brook, NJ
  • NPI 1760056824
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1124618640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 SOUTHWEST FWY STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SOUTHWEST FWY STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741529",
            "telephone_number": "832-400-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLATHUMADOM",
        "first_name": "FANCIMOL",
        "credential": "BSN, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "712785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandhya Palla Ramesh
• Palladium Anesthesia Services, PA
• Ernesto F Pallais, MPT
• Martin Pallares Perez, MD
• Mary Pallares
• Sanjay Rajashekar Pallegar, M.D.
• Palliative Care Saint Lukes LLC
• Palliative Quality Care
• Matthew Evan Pallini, OTR
• Megan German Pallister, M.D.

• Registered Nurse in Houston, TX
• Providers in Houston, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.