Individual provider Active NPI

Ganesh Bala Maniam, MD

  • Dermatology Physician
  • Houston, TX
National Provider Identifier
1720669351
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
W0222 Issued in TX
Practice address
1977 Butler Blvd
Houston, TX 77030-4101
Phone
(713) 798-6131
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X W0222 TX Primary
Dermatopathology Physician 207ND0900X W0222 TX

Addresses

Primary practice location

1977 Butler Blvd
Houston, TX 77030-4101

Mailing address

1 Baylor PLZ
Houston, TX 77030-3498
Phone (713) 798-4951

Other practice location 1

22659 US-59
Suite 140
Kingwood, TX 77339
Phone (281) 973-4159

Other practice location 2

1 Baylor Plz
Houston, TX 77030-3498
Phone (713) 798-4951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251017003024 TX Practitioner - Dermatology 1052795036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Texas Tech University Health Science Center School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiant Dermatology and Aesthetics PLLCGroup PAC ID 5799075917, 7 clinicians

Practice addresses (Care Compare)

22659 Hwy 59 N
Suite 140
Kingwood, TX 77339-4406
Phone (281) 973-4159

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
W0222TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Dermatology and Aesthetics PLLC Dermatology CurrentSince Aug 29, 2025 Accepting new patients
Cardiovascular Association, P.L.L.C Past Accepting new patients

Locations

213 S College Ave
Ste A
Cleveland, TX 77327
Phone (281) 973-4159

9240 N Sam Houston Pkwy E
Ste 201
Humble, TX 77396
Phone (281) 318-5354

22659 Highway 59 N
Ste 140
Kingwood, TX 77339
Phone (281) 713-5288

2255 E Mossy Oaks Rd
Ste 500
Spring, TX 77389
Phone (832) 232-5658

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1720669351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303498",
            "telephone_number": "713-798-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 BUTLER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "713-798-6131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22659 US-59",
            "address_2": "Suite 140",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "77339",
            "country_code": "US",
            "telephone_number": "281-973-4159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Baylor Plz",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303498",
            "country_code": "US",
            "telephone_number": "713-798-4951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANIAM",
        "first_name": "GANESH",
        "middle_name": "BALA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "W0222",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TX",
            "license": "W0222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.