Active NPI
Mammen Ashish Sam, M.D.
- Internal Medicine Physician
- Temple, TX
National Provider Identifier
1689814386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MT182731
- Practice address
- 2416 S 13TH St Apt 626
Temple, TX 76504-7815 - Phone
- (254) 421-1598
- NPI assigned
- Feb 20, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MT182731 | PA | Primary |
Addresses
Primary practice location
2416 S 13TH St Apt 626
Temple, TX 76504-7815
Mailing address
929 Gessner
Suite 2450
Houston, TX 77024-2593
Phone (713) 464-9939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT182731 | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506556800000",
"number": "1689814386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 GESSNER",
"address_2": "SUITE 2450",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770242593",
"telephone_number": "713-464-9939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2416 S 13TH ST APT 626",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765047815",
"telephone_number": "254-421-1598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAM",
"first_name": "MAMMEN",
"middle_name": "ASHISH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-20",
"last_updated": "2017-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MT182731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.