Provider Demographics
NPI:1184186173
Name:VASHISTHA, KIRTIVARDHAN (MBBS)
Entity type:Individual
Prefix:DR
First Name:KIRTIVARDHAN
Middle Name:
Last Name:VASHISTHA
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2550
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1538
Mailing Address - Country:US
Mailing Address - Phone:713-486-1651
Mailing Address - Fax:713-486-6728
Practice Address - Street 1:6400 FANNIN ST STE 2550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1538
Practice Address - Country:US
Practice Address - Phone:210-421-2504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty