Northwest Infectious Disease and Travel Medicine, PA

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

L5950 Issued in TX

Legal business name

NORTHWEST INFECTIOUS DISEASE AND TRAVEL MEDICINE, PA

Practice address

5509 Cornish St
Houston, TX 77007-4303

Phone

(832) 831-5089

Fax

(713) 360-7715

NPI assigned

Apr 19, 2006

Last updated

Jun 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Pornthep Wattanamano, MDNPI 1295738516

Title

President

Phone

(713) 384-3229

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pornthep Wattanamano, MD

  • Infectious Disease Physician
  • San Diego, CA
  • NPI 1295738516
  Authorized official Same address or phone

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1427013978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 CORNISH ST.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770074303",
            "telephone_number": "832-831-5089",
            "fax_number": "713-360-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 CORNISH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770074303",
            "telephone_number": "832-831-5089",
            "fax_number": "713-360-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INFECTIOUS DISEASE AND TRAVEL MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "WATTANAMANO",
        "authorized_official_first_name": "PORNTHEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-384-3229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L5950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC8420",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELDS",
            "identifier": "0097LZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171630001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Houston Psychiatry PLLC
• Northwest Houston Surgery Center, LLC.
• Northwest Houston Wellness Center
• Northwest Hyperbaric Specialists PA
• Northwest Infectious Disease and Travel Medicine, P.a.
• Northwest Injury & Wellness Center
• Northwest Internal Medicine Specialists PLLC
• Northwest Med Care PA
• Northwest Med Group
• Northwest Medcare PLLC

• Infectious Disease Physician in Houston, TX
• Providers in Houston, TX by specialty
• Infectious Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.