Provider Demographics
NPI:1740473305
Name:GUTHIKONDA, LALITHA (MD)
Entity type:Individual
Prefix:DR
First Name:LALITHA
Middle Name:
Last Name:GUTHIKONDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11914 ASTORIA BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6049
Mailing Address - Country:US
Mailing Address - Phone:832-325-7080
Mailing Address - Fax:713-512-2239
Practice Address - Street 1:8810 HIGHWAY 6
Practice Address - Street 2:SUITE 100
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7104
Practice Address - Country:US
Practice Address - Phone:832-325-7080
Practice Address - Fax:713-512-2239
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP40562084P0804X, 2084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FZ619OtherBCBS
TX332623303OtherCSHCN
TX332623302Medicaid
TX332623302Medicaid