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General NPI Number Information
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NPI Number | 1801327762
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Entity Type | Organization
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Legal Business Name | SIRI PARVATANENI MD PA
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 10800 GOSLING RD UNIT 130653
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City | SPRING
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State | TX
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Zip | 77393-4032
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Country | US
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Telephone | 409-200-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 10800 GOSLING RD
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City | SPRING
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State | TX
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Zip | 77393-4001
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Country | US
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Telephone | 409-200-1950
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SIRISHA PARVATANENI
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Credential | M.D.
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Telephone | 409-200-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | P0464
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License Number State | TX
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