Individual
DR. SRIVANI THATIKONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
805 W 37TH ST, AUSTIN, TX 78705-1171
(512) 421-4280
(512) 454-4575
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-31575
KS
2085R0001X
Radiation Oncology Physician
Primary
04-31575
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215453601
—
TX
05
—
215453602
—
TX
01
—
P00911449
RAILROAD MEDICARE
TX
Enumeration date
06/01/2006
Last updated
06/06/2011
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