MEDICARE: SRINIVASALU KRISHNAPPA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183700000X	Pharmacy Technician
2	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1841522257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRINIVASALU KRISHNAPPA MD

Provider Business Mailing Address
First Line	:	1600 ELDRIDGE PKWY
Second Line	:	4004
City	:	HOUSTON
State	:	TX
Zip	:	77077-1600
Country	:	US
Telephone Number	:	918-625-6567
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 ELDRIDGE PKWY
Second Line	:	4004
City	:	HOUSTON
State	:	TX
Zip	:	77077-1600
Country	:	US
Telephone Number	:	918-625-6567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2010
Last Update Date	:	02/10/2010

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