Provider Demographics
NPI:1588394993
Name:ADDURU, RON (DPM)
Entity type:Individual
Prefix:DR
First Name:RON
Middle Name:
Last Name:ADDURU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12121 RICHMOND AVE STE 417
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2439
Mailing Address - Country:US
Mailing Address - Phone:281-597-1630
Mailing Address - Fax:281-531-9600
Practice Address - Street 1:12121 RICHMOND AVE STE 417
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2439
Practice Address - Country:US
Practice Address - Phone:281-597-1630
Practice Address - Fax:281-531-9600
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26070969213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty