Provider Demographics
NPI:1043448103
Name:KUDITHIPUDI, VENU (MD)
Entity Type:Individual
Prefix:DR
First Name:VENU
Middle Name:
Last Name:KUDITHIPUDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7026 OLD KATY RD STE 276
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2187
Mailing Address - Country:US
Mailing Address - Phone:713-621-7436
Mailing Address - Fax:281-674-8308
Practice Address - Street 1:1 HURLEY PLZ
Practice Address - Street 2:7 WEST
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503
Practice Address - Country:US
Practice Address - Phone:810-232-7000
Practice Address - Fax:810-232-7020
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31.1266522085R0202X
OH390200000X
TXR55842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program