Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | TEMPORARY | TX |
NPI | 1649400177 |
---|---|
Provider Name | Poyyapakkam R Srivaths |
First Address | Houston, TX 77046-0297 |
Second Address | Houston, TX 77030-1608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2009 |
Last Update Date | 22/02/2011 |