Provider Demographics
NPI:1932359866
Name:TEEGAVARAPU, PURNIMA SRAVANTI
Entity Type:Individual
Prefix:
First Name:PURNIMA SRAVANTI
Middle Name:
Last Name:TEEGAVARAPU
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 1:6620 MAIN ST STE 1350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2342
Mailing Address - Country:US
Mailing Address - Phone:713-798-3750
Mailing Address - Fax:713-798-3342
Practice Address - Street 1:6620 MAIN ST STE 1350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2342
Practice Address - Country:US
Practice Address - Phone:713-798-3750
Practice Address - Fax:713-798-3342
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7356207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology