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General NPI Number Information
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NPI Number | 1093991259
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Entity Type | Organization
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Legal Business Name | VENKAT SRINIVASAN, MD, PA
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 102 PALO ALTO RD 300
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City | SAN ANTONIO
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State | TX
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Zip | 78211-3791
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Country | US
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Telephone | 210-928-2273
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Fax | 210-928-7272
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Provider Business Mailing Address
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Address Line | PO BOX 241990
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City | SAN ANTONIO
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State | TX
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Zip | 78224-8990
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Country | US
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Telephone | 210-928-2273
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Fax | 210-928-7272
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VENKAT SRINIVASAN
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Credential |
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Telephone | 210-928-2273
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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 | L5139
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License Number State | TX
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