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General NPI Number Information
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NPI Number | 1952376758
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Entity Type | Individual
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Provider Name | C SREENIVASAN
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 800 QUAIL CREEK DR STE 101
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City | AMARILLO
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State | TX
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Zip | 79124-1634
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Country | US
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Telephone | 806-355-8911
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Fax | 806-355-3182
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Provider Business Mailing Address
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Address Line | 800 QUAIL CREEK DR STE 101
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City | AMARILLO
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State | TX
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Zip | 79124-1634
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Country | US
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Telephone | 806-355-8911
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Fax | 806-355-3182
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | G6622
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License Number State | TX
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