Provider Demographics
NPI:1649793928
Name:KINGWOOD INFUSION CENTER PLLC
Entity type:Organization
Organization Name:KINGWOOD INFUSION CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNEPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-609-4011
Mailing Address - Street 1:19701 KINGWOOD DR STE 9
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3775
Mailing Address - Country:US
Mailing Address - Phone:281-609-4011
Mailing Address - Fax:
Practice Address - Street 1:19701 KINGWOOD DR
Practice Address - Street 2:BUILDING 9
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-609-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty