Individual
RADHESHYAM MIRYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3017 S ISLAND DR, SEABROOK, TX 77586-1649
(832) 541-8155
Mailing address
3017 S ISLAND DR, SEABROOK, TX 77586-1649
(832) 541-8155
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L1940
TX
207Q00000X
Family Medicine Physician
L1940
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150348401
—
TX
Enumeration date
10/06/2006
Last updated
08/27/2013
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