Timothy P. Bohan, PH.D.,M.D.,PA

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

H3784 Issued in TX

Practice address

6400 Fannin Street
Suite 2740
Houston, TX 77030-1539

Phone

(713) 621-4422

Fax

(713) 621-4055

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant, Doctor of Philosophy

Practice roles

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.

• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506

  Single Specialty

  NPD (past)
• Timothy P. Bohan PH.D., M.D. PA

  • Specialist
  • Houston, TX
  • NPI 1184845042
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1669426490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN STREET",
            "address_2": "SUITE 2740",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301539",
            "telephone_number": "713-621-4422",
            "fax_number": "713-621-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN STREET",
            "address_2": "SUITE 2740",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301539",
            "telephone_number": "713-621-4422",
            "fax_number": "713-621-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHAN",
        "first_name": "TIMOTHY",
        "middle_name": "P.",
        "credential": "PH.D.,M.D.,PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "TX",
            "license": "H3784",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TX",
            "license": "H3784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD TX",
            "identifier": "0009AT",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136295612",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Boglin
• Yefim W Bogomolny, M.D.
• Dmytro Bogunov, SA-C
• Justin Ikem Bogwu, M.D.
• Sarah Bohac
• Ashlee Bohanon
• Bohica, Inc.
• Pedram Bohluli, D.D.S.,M.S., PH.D.
• Rayna Wilson Bohmann, SLP
• Sarah Chelsea Bohn, M.A., CCC-SLP, CLC

• Developmental - Behavioral Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Developmental - Behavioral Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.