Provider Demographics
NPI:1972559078
Name:YENDRU, SRINIVAS (DO)
Entity Type:Individual
Prefix:DR
First Name:SRINIVAS
Middle Name:
Last Name:YENDRU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 N WOODLAWN ST
Mailing Address - Street 2:DEPT. OF ANESTHESIOLOGY
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-2729
Mailing Address - Country:US
Mailing Address - Phone:316-210-4335
Mailing Address - Fax:316-773-6401
Practice Address - Street 1:2610 N WOODLAWN ST
Practice Address - Street 2:DEPT. OF ANESTHESIOLOGY
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220-2729
Practice Address - Country:US
Practice Address - Phone:316-210-4335
Practice Address - Fax:316-773-6401
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7933207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I13522Medicare UPIN