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General NPI Number Information
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NPI Number | 1336298199
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Entity Type | Individual
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Provider Name | SRINIVAS R PANJA MD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 19701 KINGWOOD DR BLDG 4, STE A
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City | KINGWOOD
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State | TX
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Zip | 77339
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Country | US
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Telephone | 713-936-2966
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 131913
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City | SPRING
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State | TX
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Zip | 77393-1913
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Country | US
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Telephone | 713-936-2966
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Fax |
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 44673
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | N7647
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License Number State | TX
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