Provider Demographics
NPI:1952411993
Name:TITUS K. VENYAH, MD, PA
Entity Type:Organization
Organization Name:TITUS K. VENYAH, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TITUS
Authorized Official - Middle Name:KOFI
Authorized Official - Last Name:VENYAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-588-5604
Mailing Address - Street 1:8019 W GRAND PKWY S
Mailing Address - Street 2:SUITE 1060 #369
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1601
Mailing Address - Country:US
Mailing Address - Phone:832-588-5604
Mailing Address - Fax:281-239-2470
Practice Address - Street 1:21415 WINDING PATH WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-3605
Practice Address - Country:US
Practice Address - Phone:832-588-5604
Practice Address - Fax:281-239-2470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7590208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0057QSOtherBCBS
TX172995603Medicaid
TX00W907Medicare PIN
TX172995603Medicaid