MEDICARE: SUDHA M. ROYAPPA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	L8180	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F9291	OTHER	TX	MEDICARE

General Provider Information

NPI Number	:	1134120637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUDHA M. ROYAPPA M.D.

Provider Business Mailing Address
First Line	:	8210 WALNUT HILL LN
Second Line	:	SUITE 306
City	:	DALLAS
State	:	TX
Zip	:	75231-4405
Country	:	US
Telephone Number	:	214-306-4030
Fax Number	:	214-242-6758

Provider Business Practice Location Address
First Line	:	8210 WALNUT HILL LN
Second Line	:	SUITE 306
City	:	DALLAS
State	:	TX
Zip	:	75231-4405
Country	:	US
Telephone Number	:	214-306-4030
Fax Number	:	214-242-6758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	11/25/2008

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