Provider Demographics
NPI:1982929253
Name:DURGAM, PREETHI (DO)
Entity Type:Individual
Prefix:DR
First Name:PREETHI
Middle Name:
Last Name:DURGAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SCHOOL ST STE 20
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4597
Mailing Address - Country:US
Mailing Address - Phone:281-357-5678
Mailing Address - Fax:281-357-8765
Practice Address - Street 1:455 SCHOOL ST STE 20
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4597
Practice Address - Country:US
Practice Address - Phone:281-357-5678
Practice Address - Fax:281-357-8765
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ53952084E0001X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy