Provider Demographics
NPI:1740569946
Name:ELAYAPPEN, AVANIKKHA SHRI (MD)
Entity Type:Individual
Prefix:
First Name:AVANIKKHA
Middle Name:SHRI
Last Name:ELAYAPPEN
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:UTMB CHILDRENS HOSPITAL 3 230
Mailing Address - Street 2:301 UNIVERSITY BLVD
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0354
Mailing Address - Country:US
Mailing Address - Phone:520-903-4059
Mailing Address - Fax:
Practice Address - Street 1:UTMB CHILDRENS HOSPITAL 3 230
Practice Address - Street 2:301 UNIVERSITY BLVD
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0354
Practice Address - Country:US
Practice Address - Phone:520-903-4059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0040957208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics