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Individual

GOLLAVELLI JYOTHI KRISHNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
208 OAK DR S, SUITE 700, LAKE JACKSON, TX 77566-5790
(979) 230-4852
(979) 230-4863
Mailing address
208 OAK DR S, SUITE 700, LAKE JACKSON, TX 77566-5790
(979) 230-4852
(979) 230-4863

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
193726
NY
2084P0800X
Psychiatry Physician
Primary
P1190
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01688384
NY
Enumeration date
06/20/2008
Last updated
03/10/2016
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