Healthcare Provider Details

I. General information

NPI: 1891809216
Provider Name (Legal Business Name): SRINIVASACHARY TAMIRISA,M.D,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 SOUTHWEST FWY 530
HOUSTON TX
77074-1802
US

IV. Provider business mailing address

7777 SOUTHWEST FWY 530
HOUSTON TX
77074-1802
US

V. Phone/Fax

Practice location:
  • Phone: 713-271-2708
  • Fax: 713-271-7454
Mailing address:
  • Phone: 713-271-2708
  • Fax: 713-271-7454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: SRINIVASACHARY TAMIRISA
Title or Position: OWNER
Credential: M.D.,
Phone: 713-271-2708