Tamirisa, Praveen K
Tamirisa, Praveen K is an individual health care provider with primary practice located at 11803 South Fwy Ste 115 , Burleson TX 76028-7028. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Tamirisa, Praveen K can be contacted via phone (817) 293-8441.Contact Information
Primary practice address
11803 South Fwy Ste 115
Burleson TX 76028-7028
Phone: (817) 293-8441
Fax: (817) 293-8505
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 4301077499 | Michigan |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 35079630T | Ohio |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 4301077499 | Michigan |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | S2912 | Texas |
Profile Details
| NPI number | 1679577597 |
|---|---|
| LBN Legal business name | Tamirisa, Praveen K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Oct 28th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679577597 | NPPES |
| Ohio | MEDICAID | 2258971 | |
| Ohio | Other | P00711902 |
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