SRI B GOTTIMUKKALA (NPI# 1205173614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205173614 |
| Entity Type | Individual |
| Full Name | SRI B GOTTIMUKKALA |
| Credential | M.D |
| Practice Address |
2060 Space Park Dr Suite 410 Houston TX 77058-3600 |
| Practice Telephone | 8327832330 |
| Practice Fax Number | 2813331731 |
| Mailing Telephone | 8327832330 |
| Mailing Fax Number | 2813331731 |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2016-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Q3877 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 8FK130 | 01 |
| TX | 351833402 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 8FX392 | 01 |
| TX | 351833401 | 05 |
| Street Address |
2060 SPACE PARK DR SUITE 410 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77058-3600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457359580 | Francoise Thomas Vandaele | Specialist | 2060 Space Park Dr, Suite 410, Houston, TX 77058-3600 | 2005-07-12 |
| 1194169912 | Gordon Bellah Jr. | Specialist | 2060 Space Park Dr, Suite 204, Houston, TX 77058-3600 | 2013-04-23 |
| 1538313838 | Nadeem A Malhi Md Pa | Family Medicine | 2060 Space Park Dr, Houston, TX 77058-3600 | 2008-11-13 |
| 1225282734 | Azmat Khan Md Pa | Internal Medicine | 2060 Space Park Dr, Houston, TX 77058-3600 | 2008-11-11 |
| 1346490083 | Akhila Vijayakumar | Psychiatry & Neurology | 2060 Space Park Dr, Suite 104, Houston, TX 77058-3600 | 2008-09-30 |
| 1649457490 | Anitra Johnson Md Pa | Specialist | 2060 Space Park Dr, Suite 208, Houston, TX 77058-3600 | 2008-01-23 |
| 1851590954 | Mumtaz Suleman, M.d., P.a. | Psychiatry & Neurology | 2060 Space Park Dr, Suite 404, Houston, TX 77058-3600 | 2007-07-17 |
| 1700084522 | Kyle Wayne Stephens | Internal Medicine | 2060 Space Park Dr, Suite 100, Houston, TX 77058-3600 | 2007-07-03 |
| 1265636831 | Gabriel H Lee | Internal Medicine | 2060 Space Park Dr, Suite 200, Houston, TX 77058-3600 | 2007-06-14 |
| 1235340589 | Venkata Samavedi | Internal Medicine | 2060 Space Park Dr, Suite 406, Houston, TX 77058-3600 | 2007-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699248807 | Jolly Joseph | Nurse Practitioner | 18300, Houston Methodist, Houston, TX 77058 | 2019-01-10 |
| 1700372992 | Jasmin Elise Auzenne | Audiologist | 17625 El Camino Real Ste 155, Houston, TX 77058 | 2018-07-10 |
| 1053801225 | Dialyspa Vii LLC | Clinic/Center | 1411 Bonner St., Houston, TX 77058 | 2018-05-14 |
| 1699263285 | Pneucare, LLC | Durable Medical Equipment & Medical Supplies | 1322 Space Park Dr Ste C120, Houston, TX 77058 | 2018-04-29 |
| 1972005189 | Limy Fernandus | Nurse Practitioner | 985 E Nasa Pkwy, Houston, TX 77058 | 2018-03-03 |
| 1033623616 | Sigi Paul | Nurse Practitioner | 1210 El Camino Village Dr., Houston, TX 77058 | 2017-11-19 |
| 1881107845 | Jennifer Elise Hobson | Counselor | 1322 Space Park Dr Ste B123, Houston, TX 77058 | 2017-11-13 |
| 1174035778 | Agrarian Wellness, LLC | Registered Nurse | 17000 El Camino Real Ste 209, Houston, TX 77058 | 2017-11-04 |
| 1013468073 | Cynthia Bandemer | Counselor | 17300 El Camino Real Ste 107d, Houston, TX 77058 | 2016-10-14 |
| 1043698533 | Hopewell Home Healthcare LLC | Nursing Care | 18090 Kings Row, Houston, TX 77058 | 2015-05-15 |
| Find all providers in zip 77058 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487273 | Victoria Ann Petruzzi | Obstetrics & Gynecology | 1401 St. Joseph Pkwy., Sks1106a, Houston, TX 77002 | 2020-05-04 |
| 1962052605 | Sharee Anne Valencia | Obstetrics & Gynecology | 11947 North Fwy, Houston, TX 77060-1700 | 2019-09-15 |
| 1881251239 | Andrea Marie Costello | Obstetrics & Gynecology | Gme, Attn: Dottie Mersinger, 6670 Bertner Ave., R2-216, Houston, TX 77030 | 2019-05-21 |
| 1144784406 | Martha Laird | Obstetrics & Gynecology | 5618 Bankside Dr, Houston, TX 77096-6119 | 2019-01-30 |
| 1588134407 | The Women's Health Solution | Obstetrics & Gynecology | 5751 Blythewood St Ste 200, Houston, TX 77021-5404 | 2018-12-04 |
| 1720569411 | Champions Women's Center, P.a. | Obstetrics & Gynecology | 17070 Red Oak Dr Ste 400, Houston, TX 77090-2616 | 2018-08-22 |
| 1942711668 | Total Women's Care Pllc | Obstetrics & Gynecology | 2050 North Loop W Ste 130, Houston, TX 77018-8111 | 2017-10-20 |
| 1821451667 | L. Natalie Carroll, M.d. P A | Obstetrics & Gynecology | 2656 S Loop W Ste 575, Houston, TX 77054-5622 | 2016-03-30 |
| 1841652120 | Iris Alejandra Trochez Valladares | Obstetrics & Gynecology | 13215 Dotson Rd Ste 200, Houston, TX 77070-4535 | 2016-03-24 |
| 1255702544 | Leen Al-hafez | Obstetrics & Gynecology | 3105 Norfolk St, Apartment 18305, Houston, TX 77098-2916 | 2015-10-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.