Provider Demographics
NPI:1275595985
Name:NIEMANN, BOBBY (MD)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:
Last Name:NIEMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 FROSTWOOD DR SUITE 2.300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-338-6346
Mailing Address - Fax:
Practice Address - Street 1:18955 N MEMORIAL DR STE 360
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4396
Practice Address - Country:US
Practice Address - Phone:281-319-8530
Practice Address - Fax:281-319-8570
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12361745-12052084N0400X
TXE45662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P6819OtherBCBS
TX124988013Medicaid
TX124988009Medicaid
TX297088YKRCMedicare PIN
TX8L16069Medicare PIN
TX124988009Medicaid