Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | T0710 | TX |
NPI | 1154634566 |
---|---|
Provider Name | Dr. Sreenivas Kumar Avula |
First Address | San Antonio, TX 78207-3255 |
Second Address | San Antonio, TX 78207-3108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2010 |
Last Update Date | 09/09/2021 |