Provider Demographics
NPI:1942528831
Name:SARVA SKIN CENTER, PLLC
Entity Type:Organization
Organization Name:SARVA SKIN CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:YALAMANCHILI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-429-4929
Mailing Address - Street 1:23920 KATY FWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1341
Mailing Address - Country:US
Mailing Address - Phone:832-429-4929
Mailing Address - Fax:713-758-0989
Practice Address - Street 1:23920 KATY FWY
Practice Address - Street 2:SUITE 410
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1341
Practice Address - Country:US
Practice Address - Phone:832-429-4929
Practice Address - Fax:713-758-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN5495207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty