MEDICARE: DR. THRIVENI RAMKUMAR VELLORE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD420822	PA
2	207Q00000X	Family Medicine Physician	P5311	TX

General Provider Information

NPI Number	:	1225003270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THRIVENI RAMKUMAR VELLORE M.D.

Provider Business Mailing Address
First Line	:	11452 SPACE CENTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3599
Country	:	US
Telephone Number	:	713-486-6200
Fax Number	:	713-486-6294

Provider Business Practice Location Address
First Line	:	11452 SPACE CENTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3599
Country	:	US
Telephone Number	:	713-486-6200
Fax Number	:	713-486-6294

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	04/29/2024

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