Provider Demographics
NPI:1952621294
Name:GARNEPUDI, KEVIN (DO)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:GARNEPUDI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19701 KINGWOOD DR.
Mailing Address - Street 2:BUILDING #9
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-609-4011
Mailing Address - Fax:713-456-2813
Practice Address - Street 1:19701 KINGWOOD DR.
Practice Address - Street 2:BUILDING #9
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-609-4011
Practice Address - Fax:713-456-2813
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10037628207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine