Provider Demographics
NPI:1811251275
Name:PAVULURI, SPRIHA (MD)
Entity type:Individual
Prefix:
First Name:SPRIHA
Middle Name:
Last Name:PAVULURI
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 1:1832 CANVASBACK
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-3530
Mailing Address - Country:US
Mailing Address - Phone:630-639-1937
Mailing Address - Fax:319-384-8476
Practice Address - Street 1:8200 DODGE ST # NE68114
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:630-639-1937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-30
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE345582084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology