Betty Kalianda Oetama, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

L6132 Issued in TX

Practice address

2525 West Bellfort Street
Ste 120
Houston, TX 77054-5024

Phone

(713) 741-6677

Fax

(713) 748-5860

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Brown & Associates Medical Laboratories LLP

  • Clinical Medical Laboratory
  • Houston, TX
  • NPI 1588649016

  Anatomic Pathology & Clinical Pathology

  NPD
• Brown & Associates Medical Laboratories, LLP

  • Anatomic Pathology & Clinical Pathology Physician
  • Houston, TX
  • NPI 1912981747
  NPD

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1720049356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421849",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772421849",
            "telephone_number": "713-559-6929",
            "fax_number": "713-559-6928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 WEST BELLFORT STREET",
            "address_2": "STE 120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545024",
            "telephone_number": "713-741-6677",
            "fax_number": "713-748-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OETAMA",
        "first_name": "BETTY",
        "middle_name": "KALIANDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AL",
            "license": "00025871",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L6132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176504201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176504202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Odyssey TLC Adult Daycare,Inc.
• Jasandra Lourdes Oeffinger, LPC
• Abigail Oehler, LPC, CRC
• Laura Oehler, APRN, FNP-C
• Gregory Keith Oelfke, D.D.S.
• Daryn Ofczarzak, SLP
• Maria Ofeno
• Off-Label LLC
• Kyrah Jirrecce' Offett, PHARMD
• Office Anesthesiology Consultants of Texas LLC

• Anatomic Pathology & Clinical Pathology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Anatomic Pathology & Clinical Pathology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.