Provider Demographics
NPI:1861541922
Name:DAVE, AMISH S (MD PHD)
Entity type:Individual
Prefix:DR
First Name:AMISH
Middle Name:S
Last Name:DAVE
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1901
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-1100
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1901
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5005207R00000X, 207RC0000X, 207RC0001X
CAA87687207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211285601Medicaid
TX211285602Medicaid
TX8CG506OtherBCBS
TX211285609Medicaid
TX1861541922OtherBLUE CROSS BLUE SHIELD
TX211285603Medicaid
TXP00849863OtherMEDICARE RAILROAD
TXP01039321OtherRR MEDICARE
NE$$$$$$$$$Medicaid
NE$$$$$$$$$Medicaid
TX8L26402Medicare PIN
CAI48721Medicare UPIN
TX8L26397Medicare PIN
TX332486YUD8Medicare PIN
TX332486YQ64Medicare PIN
TXP00849863OtherMEDICARE RAILROAD
TX332486ZSWCMedicare PIN
TX8CG506OtherBCBS
TX211285609Medicaid
TXTXB145739Medicare PIN
TX211285601Medicaid
TX211285603Medicaid