Provider Demographics
NPI:1225569130
Name:CHITTURI, KALYAN RAGHAVENDRA (DO)
Entity Type:Individual
Prefix:
First Name:KALYAN
Middle Name:RAGHAVENDRA
Last Name:CHITTURI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SM 1001
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-5114
Mailing Address - Fax:713-790-3023
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SM 1001
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-5114
Practice Address - Fax:713-790-3023
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program