Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 5541 | NE |
N | 208200000X | Surgeon | 6026 | GA |
N | 208600000X | Surgeon | 6026 | GA |
Y | 208200000X | Surgeon | Q9558 | TX |
Y | 208600000X | Surgeon | Q9558 | TX |
NPI | 1023208949 |
---|---|
Provider Name | Govardhana Rao Yannam |
First Address | Houston, TX 77058-3674 |
Second Address | Houston, TX 77058-3674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
373627401 | (05) | TX |