Provider Demographics
NPI:1871029348
Name:GREATER HOUSTON INFECTIOUS DISEASE ASSOCIATES
Entity Type:Organization
Organization Name:GREATER HOUSTON INFECTIOUS DISEASE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNEPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-609-4011
Mailing Address - Street 1:19701 KINGWOOD DR
Mailing Address - Street 2:BUILDING #9
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3773
Mailing Address - Country:US
Mailing Address - Phone:281-609-4011
Mailing Address - Fax:
Practice Address - Street 1:19701 KINGWOOD DR
Practice Address - Street 2:BUILDING #9
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3773
Practice Address - Country:US
Practice Address - Phone:281-609-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5805207RI0200X
261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Single Specialty