Healthcare Provider Details

I. General information

NPI: 1700526555
Provider Name (Legal Business Name): VARSHA SRIDHAR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E 77TH ST FL 6
NEW YORK NY
10075-1851
US

IV. Provider business mailing address

301 UNIVERSITY BLVD
GALVESTON TX
77555-0565
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-4763
  • Fax:
Mailing address:
  • Phone: 832-505-1910
  • Fax: 409-747-0064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberBP10094010
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: