Basic Information
Provider Information
NPI: 1841587805
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIMACHKIEH
FirstName: AMY
MiddleName: LI
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RICHTER
OtherFirstName: AMY
OtherMiddleName: LI
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 6550 FANNIN ST.
Address2: SMITH TOWER - SUITE 1701
City: HOUSTON
State: TX
PostalCode: 77030
CountryCode: US
TelephoneNumber: 7137985900
FaxNumber: 7137985841
Practice Location
Address1: 6550 FANNIN ST
Address2: SMITH TOWER - SUITE 1701
City: HOUSTON
State: TX
PostalCode: 770302717
CountryCode: US
TelephoneNumber: 7137985900
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/28/2011
LastUpdateDate: 04/06/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XBP10039762TXY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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