Provider Demographics
NPI:1316188519
Name:PUTHALAPATTU, SOWMYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SOWMYA
Middle Name:
Last Name:PUTHALAPATTU
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 1:201 KINGWOOD MEDICAL DR
Mailing Address - Street 2:STE B200
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6016
Mailing Address - Country:US
Mailing Address - Phone:281-401-9540
Mailing Address - Fax:
Practice Address - Street 1:19502 MCKAY BLVD
Practice Address - Street 2:SUITE- 200
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5707
Practice Address - Country:US
Practice Address - Phone:281-540-8779
Practice Address - Fax:281-540-8798
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1841207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine