Provider Demographics
NPI:1770046146
Name:ANGIREKULA, ANEESH KIRAN (MD)
Entity type:Individual
Prefix:
First Name:ANEESH
Middle Name:KIRAN
Last Name:ANGIREKULA
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 1:2424 W HOLCOMBE BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1933
Mailing Address - Country:US
Mailing Address - Phone:281-886-7440
Mailing Address - Fax:281-929-0086
Practice Address - Street 1:2424 W HOLCOMBE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1933
Practice Address - Country:US
Practice Address - Phone:281-886-7440
Practice Address - Fax:281-929-0086
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU8024207KA0200X
TXBP100668302390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program