Provider Demographics
NPI:1669485546
Name:LITTLE, RAYMOND W (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:W
Last Name:LITTLE
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 1:24040 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1500
Mailing Address - Country:US
Mailing Address - Phone:281-312-0242
Mailing Address - Fax:
Practice Address - Street 1:1485 FM 1960 BYPASS RD E STE 200
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3965
Practice Address - Country:US
Practice Address - Phone:281-312-0242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0854207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
8AA750OtherBLUECROSS BLUESHIELD
1550047OtherAETNA
8F6214Medicare PIN
1550047OtherAETNA