Individual
GOTTUMUKKALA S RAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD UNIT 1466, HOUSTON, TX 77030-4000
(713) 794-5073
(713) 745-5040
Mailing address
1515 HOLCOMBE BLVD UNIT 1466, THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER, HOUSTON, TX 77030-4000
(713) 794-5073
(713) 745-5040
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
L2576
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142193501
—
TX
Enumeration date
12/08/2006
Last updated
03/27/2012
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