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General NPI Number Information
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NPI Number | 1649641960
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Entity Type | Individual
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Provider Name | VINAY HOSURU SIDDAPPA MBBS D ORTH DNB ORTH
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Gender | Male
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 2002 HOLCOMBE BLVD # 5C-288
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City | HOUSTON
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State | TX
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Zip | 77030-4211
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Country | US
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Telephone | 713-791-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 HOLCOMBE BLVD # 5C-288
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City | HOUSTON
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State | TX
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Zip | 77030-4211
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Country | US
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Telephone | 713-791-1414
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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 | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | R - 10452
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 298757-1
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License Number State | NY
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