Provider Demographics
NPI:1235340589
Name:SAMAVEDI, VENKATA (MD)
Entity type:Individual
Prefix:
First Name:VENKATA
Middle Name:
Last Name:SAMAVEDI
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 1:704 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75633-1463
Mailing Address - Country:US
Mailing Address - Phone:903-694-4824
Mailing Address - Fax:903-694-4874
Practice Address - Street 1:704 DAVIS ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633-1463
Practice Address - Country:US
Practice Address - Phone:903-694-4824
Practice Address - Fax:903-694-4823
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023011534208M00000X
TXM9629207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist