Provider Demographics
NPI:1093958837
Name:SRINIBASA MURPHY, VENKATESH C S (M S, PH D)
Entity Type:Individual
Prefix:MR
First Name:VENKATESH
Middle Name:C S
Last Name:SRINIBASA MURPHY
Suffix:
Gender:M
Credentials:M S, PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-1214
Mailing Address - Country:US
Mailing Address - Phone:409-670-1536
Mailing Address - Fax:
Practice Address - Street 1:1905 THOUSAND OAKS DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77632-1214
Practice Address - Country:US
Practice Address - Phone:409-670-1536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist