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General NPI Number Information
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NPI Number | 1245661784
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Entity Type | Organization
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Legal Business Name | EVEREST INTERNAL MEDICINE P.A.
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 920 MEDICAL PLAZA DR SUITE 350
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City | SHENANDOAH
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State | TX
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Zip | 77380-3260
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Country | US
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Telephone | 713-876-5260
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Fax |
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Provider Business Mailing Address
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Address Line | 4775 W PANTHER CREEK DR #440-113
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City | THE WOODLANDS
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State | TX
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Zip | 77381-3592
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHARMILA NAIDU
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Credential | M.D.
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Telephone | 713-876-5260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | M4892
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M4892
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License Number State | TX
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