Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 45666 | TX |
N | 111NI0900X | Internist | 45666 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | 45666 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | 46916 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | 47206 | TX |
Y | 207RC0000X | Internist - Cardiovascular Disease | 4790 | TX |
NPI | 1003217522 |
---|---|
Provider Name | Dr. Srikanth Koneru |
First Address | Houston, TX 77030-2348 |
Second Address | Houston, TX 77030-2348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2014 |
Last Update Date | 07/10/2021 |