MEDICARE: DR. MADHUREETA ACHARI 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	2084N0400X	Neurology Physician	G47254	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588689442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADHUREETA ACHARI MD

Provider Business Mailing Address
First Line	:	1411 HEIGHTS BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4248
Country	:	US
Telephone Number	:	832-793-7530
Fax Number	:	832-793-7540

Provider Business Practice Location Address
First Line	:	1411 HEIGHTS BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4248
Country	:	US
Telephone Number	:	832-793-7530
Fax Number	:	832-793-7540

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	04/05/2023

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