Individual
SAIVENKAT H VAGVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1101 WOLF LAKE DR # 100, GEORGETOWN, TX 78628-3778
(877) 324-3310
Mailing address
1101 WOLF LAKE DR # 100, GEORGETOWN, TX 78628-3778
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
U9791
TX
2085R0202X
Diagnostic Radiology Physician
1831546571
WI
2085R0202X
Diagnostic Radiology Physician
69906
WI
390200000X
Student in an Organized Health Care Education/Training Program
5101022440
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100081240
—
WI
Enumeration date
05/23/2016
Last updated
01/06/2025
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