MEDICARE: DR. RAGHUNANDAN MUPPIDI 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	E4546	AR
2	207RC0000X	Cardiovascular Disease Physician	Q9205	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164478301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAGHUNANDAN MUPPIDI M.D.

Provider Business Mailing Address
First Line	:	1140 WESTMONT DR STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4368
Country	:	US
Telephone Number	:	713-899-0298
Fax Number	:	806-705-8029

Provider Business Practice Location Address
First Line	:	1140 WESTMONT DR STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4368
Country	:	US
Telephone Number	:	713-899-0298
Fax Number	:	806-705-8029

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	10/18/2023

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Directions to “ DR. RAGHUNANDAN MUPPIDI M.D.” Practice Location

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