Healthcare Provider Details

I. General information

NPI: 1447614664
Provider Name (Legal Business Name): KAVINA JUNEJA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 PINECROFT DR STE 255
SHENANDOAH TX
77380-3286
US

IV. Provider business mailing address

9200 PINECROFT DR STE 255
SHENANDOAH TX
77380-3286
US

V. Phone/Fax

Practice location:
  • Phone: 281-419-8400
  • Fax: 281-292-1972
Mailing address:
  • Phone: 281-419-8400
  • Fax: 281-292-1972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberT5142
License Number StateTX
# 2
Primary TaxonomyN
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: