Provider Demographics
NPI:1316056468
Name:KAMBLE, MADHURI VINAYAKRAO (MD)
Entity type:Individual
Prefix:
First Name:MADHURI
Middle Name:VINAYAKRAO
Last Name:KAMBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9401 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1407
Mailing Address - Country:US
Mailing Address - Phone:713-970-7687
Mailing Address - Fax:713-970-7246
Practice Address - Street 1:1502 TAUB LOOP
Practice Address - Street 2:NEURO PSYCHIATRIC CENTER
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-970-4640
Practice Address - Fax:713-970-4744
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK95782084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149198701Medicaid
TXH48612Medicare UPIN
TXP00011693Medicare PIN
TX8800K8Medicare PIN