Provider Demographics
NPI:1649975111
Name:GUDDANTI, TEJESH (MD)
Entity type:Individual
Prefix:
First Name:TEJESH
Middle Name:
Last Name:GUDDANTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 LAGUNA DEL REY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-5771
Mailing Address - Country:US
Mailing Address - Phone:832-377-7183
Mailing Address - Fax:
Practice Address - Street 1:6110 LAGUNA DEL REY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-5771
Practice Address - Country:US
Practice Address - Phone:832-377-7183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program