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NPI Code Detail

MEDICARE: DR. VIKRAM C SURAPARAJU M.D.

MEDICARE: DR. VIKRAM C SURAPARAJU 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
1390200000XStudent in an Organized Health Care Education/Training ProgramTX
2208M00000XHospitalist PhysicianN1167TX
3207R00000XInternal Medicine PhysicianN1167TX
4207P00000XEmergency Medicine PhysicianN1167TX

Other Identifiers

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

General Provider Information

NPI Number : 1164687430
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIKRAM C SURAPARAJU M.D.
Provider Business Mailing Address
First Line : 12221 N MOPAC EXPY
Second Line :
City : AUSTIN
State : TX
Zip : 78758-2401
Country : US
Telephone Number : 512-901-4009
Fax Number : 512-901-3909
Provider Business Practice Location Address
First Line : 18511 HIGHLANDER MEDICS ST
Second Line :
City : FORT BLISS
State : TX
Zip : 79906-5327
Country : US
Telephone Number : 915-742-7777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2008
Last Update Date : 03/27/2026

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