Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | R0072 | TX |
NPI | 1275752503 |
---|---|
Provider Name | Kavitha Marri |
First Address | Pasadena, TX 77504 |
Second Address | Pasadena, TX 77504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 09/06/2017 |