Provider Demographics
NPI:1346022860
Name:GOVINDU, MADHURI
Entity Type:Individual
Prefix:
First Name:MADHURI
Middle Name:
Last Name:GOVINDU
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MADHURI
Other - Middle Name:
Other - Last Name:TOOMULURU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8300 FM 1960 RD E APT 7341
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4532
Mailing Address - Country:US
Mailing Address - Phone:412-218-8333
Mailing Address - Fax:
Practice Address - Street 1:8300 FM 1960 RD E APT 7341
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4532
Practice Address - Country:US
Practice Address - Phone:412-218-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92723101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health