Individual
VARAHA TAMMISETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6411 FANNIN ST, RADIOLOGY, HOUSTON, TX 77030-1501
(713) 704-4000
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
TR00045282
WA
2085R0202X
Diagnostic Radiology Physician
FTL 42195
TX
2085R0202X
Diagnostic Radiology Physician
Primary
FTL 42635
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198189601
—
TX
01
—
198189602
CSHCN
TX
01
—
8AL154
BCBS
TX
Enumeration date
08/30/2006
Last updated
07/15/2009
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