Healthcare Provider Details

I. General information

NPI: 1942943147
Provider Name (Legal Business Name): SRUTHI YETURU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5899 PRESTON RD
FRISCO TX
75034-9586
US

IV. Provider business mailing address

5899 PRESTON RD
FRISCO TX
75034-9586
US

V. Phone/Fax

Practice location:
  • Phone: 972-782-2588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10081497
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberV9742
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: