Basic Information
Provider Information
NPI: 1871953224
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: UMMER
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1116 E 35TH PL
Address2:  
City: TULSA
State: OK
PostalCode: 74105
CountryCode: US
TelephoneNumber: 5855073840
FaxNumber:  
Practice Location
Address1: 1102 W TRENTON RD
Address2:  
City: EDINBURG
State: TX
PostalCode: 785399105
CountryCode: US
TelephoneNumber: 9563886000
FaxNumber: 9562892956
Other Information
ProviderEnumerationDate: 02/27/2016
LastUpdateDate: 01/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XS3473TXN Allopathic & Osteopathic PhysiciansPediatrics 
208M00000XS3473TXY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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