Provider Demographics
NPI:1811918311
Name:POTHURI, VANITHA REDDY (MD)
Entity type:Individual
Prefix:DR
First Name:VANITHA
Middle Name:REDDY
Last Name:POTHURI
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 1:17527 W BREMONDS BEND CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2966
Mailing Address - Country:US
Mailing Address - Phone:832-752-7279
Mailing Address - Fax:
Practice Address - Street 1:17527 W BREMONDS BEND CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2966
Practice Address - Country:US
Practice Address - Phone:832-752-7279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine