MEDICARE: ANEESH KIRAN ANGIREKULA MD

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	207KA0200X	Allergy Physician	U8024	TX
2	390200000X	Student in an Organized Health Care Education/Training Program	BP100668302	TX

General Provider Information

NPI Number	:	1770046146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANEESH KIRAN ANGIREKULA MD

Provider Business Mailing Address
First Line	:	2424 W HOLCOMBE BLVD STE 104
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1933
Country	:	US
Telephone Number	:	281-886-7440
Fax Number	:	281-929-0086

Provider Business Practice Location Address
First Line	:	2424 W HOLCOMBE BLVD STE 104
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1933
Country	:	US
Telephone Number	:	281-886-7440
Fax Number	:	281-929-0086

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

Provider Enumeration Date	:	04/11/2019
Last Update Date	:	06/28/2024

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