Provider Demographics
NPI:1265059943
Name:MARINGANTI, KRISHNAVENI (PT)
Entity type:Individual
Prefix:
First Name:KRISHNAVENI
Middle Name:
Last Name:MARINGANTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WESLAYAN ST STE 545
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5369
Mailing Address - Country:US
Mailing Address - Phone:281-940-9423
Mailing Address - Fax:
Practice Address - Street 1:2900 WESLAYAN ST STE 545
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5369
Practice Address - Country:US
Practice Address - Phone:281-940-9423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1329966225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty