Provider Demographics
NPI:1346823366
Name:VEGIVINTI, CHARAN THEJ REDDY (MD)
Entity type:Individual
Prefix:DR
First Name:CHARAN
Middle Name:THEJ REDDY
Last Name:VEGIVINTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HOLCOMBE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4000
Mailing Address - Country:US
Mailing Address - Phone:713-792-0050
Mailing Address - Fax:713-745-1827
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-792-0050
Practice Address - Fax:713-745-1827
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2024-08-20
Deactivation Date:2023-03-23
Deactivation Code:
Reactivation Date:2023-12-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program