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General NPI Number Information
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NPI Number | 1073017828
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Entity Type | Individual
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Provider Name | NITEESH CHITTURU
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Gender | Male
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 2505 SCRIPTURE ST STE 100
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City | DENTON
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State | TX
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Zip | 76201-2481
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Country | US
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Telephone | 940-320-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 1402 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1004
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Country | US
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Telephone | 314-577-8762
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Fax | 314-268-5108
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V2459
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | V2459
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License Number State | TX
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