Provider Demographics
NPI:1437312584
Name:KURUVANKA, TULSIDAS S (MD)
Entity Type:Individual
Prefix:DR
First Name:TULSIDAS
Middle Name:S
Last Name:KURUVANKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13325 HARGRAVE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4539
Mailing Address - Country:US
Mailing Address - Phone:281-469-8007
Mailing Address - Fax:281-469-8042
Practice Address - Street 1:13325 HARGRAVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4540
Practice Address - Country:US
Practice Address - Phone:281-469-8007
Practice Address - Fax:281-469-8042
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0191207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX321630101Medicaid
TX8L8548Medicare PIN
TX321630101Medicaid