Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP1-0035414 | TX |
N | 111NI0900X | Internist | BP1-0035414 | TX |
NPI | 1003040544 |
---|---|
Provider Name | Preeti Venkatraman |
First Address | Austin, TX 78701-1930 |
Second Address | Austin, TX 78701-1930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2009 |
Last Update Date | 03/04/2017 |