MEDICARE: SAMRITA UDAY VARDE MD

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	207Q00000X	Family Medicine Physician	T2522	TX

General Provider Information

NPI Number	:	1336661545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMRITA UDAY VARDE MD

Provider Business Mailing Address
First Line	:	1395 NW 167TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5710
Country	:	US
Telephone Number	:	832-709-2770
Fax Number	:

Provider Business Practice Location Address
First Line	:	DEDICATED PHYSICIANS GROUP OF TEXAS PLLC
Second Line	:	8471 GULF FREEWAY
City	:	HOUSTON
State	:	TX
Zip	:	77017-5001
Country	:	US
Telephone Number	:	832-709-2770
Fax Number	:

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

Provider Enumeration Date	:	07/10/2017
Last Update Date	:	07/21/2022

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