Individual
SREEDHAR A MANDAYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2911
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
N3861
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200404110A
—
KS
05
—
206381010
—
TX
01
—
206381011
CSHCN MEDICAID TPI
—
Enumeration date
07/25/2006
Last updated
09/28/2018
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