Provider Demographics
NPI:1588351563
Name:TANGELLAPELLI, SRIVENI (MD)
Entity type:Individual
Prefix:MS
First Name:SRIVENI
Middle Name:
Last Name:TANGELLAPELLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8508 SUMMA AVENUE
Mailing Address - Street 2:UNIT P12
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:940-758-3490
Mailing Address - Fax:225-442-5128
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-819-1129
Practice Address - Fax:225-442-5128
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program