Provider Demographics
NPI:1801329230
Name:KOVELAMUDI, ASHA
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:KOVELAMUDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 CANYON CREEK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3278
Mailing Address - Country:US
Mailing Address - Phone:254-218-3737
Mailing Address - Fax:
Practice Address - Street 1:1023 CANYON CREEK DR STE 105
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3278
Practice Address - Country:US
Practice Address - Phone:254-218-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS85952084P0800X
OK329952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry