Provider Demographics
NPI:1972941318
Name:SRINIVAS RAO MD PA
Entity Type:Organization
Organization Name:SRINIVAS RAO MD PA
Other - Org Name:TEXAS VEIN AND WELLNESS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-240-4913
Mailing Address - Street 1:11221 KATY FWY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2105
Mailing Address - Country:US
Mailing Address - Phone:281-888-1464
Mailing Address - Fax:713-640-5938
Practice Address - Street 1:11221 KATY FWY
Practice Address - Street 2:SUITE 115
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2105
Practice Address - Country:US
Practice Address - Phone:281-888-1464
Practice Address - Fax:713-640-5938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH76442085R0204X
2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty