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NPI Code Detail

MEDICARE: DR. SUDHEER M JAYAPRABHU MD

MEDICARE:  DR. SUDHEER M JAYAPRABHU  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
1207V00000XObstetrics & Gynecology PhysicianL2351TX

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 : 1639176555
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUDHEER M JAYAPRABHU MD
Provider Business Mailing Address
First Line : 2717 SUMMERHILL RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-3957
Country : US
Telephone Number : 903-792-1404
Fax Number : 903-792-2681
Provider Business Practice Location Address
First Line : 2717 SUMMERHILL RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-3957
Country : US
Telephone Number : 903-792-1404
Fax Number : 903-792-2681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 03/11/2026

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