Provider Demographics
NPI:1184852642
Name:AGRAWAL, MONICA PRIYANKA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:PRIYANKA
Last Name:AGRAWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 S GESSNER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2000
Mailing Address - Country:US
Mailing Address - Phone:713-266-7673
Mailing Address - Fax:
Practice Address - Street 1:2405 S GESSNER RD
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2000
Practice Address - Country:US
Practice Address - Phone:713-266-7673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1257207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302750001Medicaid
TXTXB161138Medicare PIN