Provider Demographics
NPI:1902893654
Name:PRAMUDJI, CHRISTINA KLEIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:KLEIN
Last Name:PRAMUDJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18300 KATY FWY STE 565
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1385
Mailing Address - Country:US
Mailing Address - Phone:281-717-4003
Mailing Address - Fax:281-206-7597
Practice Address - Street 1:18300 KATY FWY STE 565
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1385
Practice Address - Country:US
Practice Address - Phone:281-717-4003
Practice Address - Fax:281-206-7597
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4725208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8656J1OtherBLUE CROSS BLUE SHIELD
TX174630704Medicaid
TX174630702Medicaid
TX174630701Medicaid
TXP00725225OtherRAILROAD MEDICARE
TX8BV062OtherBLUECROSS BLUESHIELD OF TX
TX174630701Medicaid
TX8656J1Medicare ID - Type Unspecified
TX174630704Medicaid
TXTXB128609Medicare PIN