Provider Demographics
NPI:1033551965
Name:BONTHALA, SAVITHA (DO, MPH)
Entity Type:Individual
Prefix:
First Name:SAVITHA
Middle Name:
Last Name:BONTHALA
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15403 BAY COVE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-5821
Mailing Address - Country:US
Mailing Address - Phone:281-382-4838
Mailing Address - Fax:
Practice Address - Street 1:1300 BINZ ST FL 3
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7016
Practice Address - Country:US
Practice Address - Phone:713-285-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR88692081P0301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine