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Individual

DR. ATHI P VENKATESH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
19701 KINGWOOD DR, BLDG 3, KINGWOOD, TX 77339-3773
(281) 358-5701
(281) 358-7061
Mailing address
19701 KINGWOOD DR, BLDG 3, KINGWOOD, TX 77339-3773
(281) 358-5701
(281) 358-7061

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L7912
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00385Z
MEDICARE PIN - KINGWOOD PSYCHIATRY
TX
05
165090502
TX
01
176061302
MEDICAID - KINGWOOD PSYCHIATRY
TX
01
45D2077598
CLIA
TX
Enumeration date
01/28/2007
Last updated
05/23/2014
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