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NPI Code Detail

MEDICARE: SWARUPA K NAIDU

MEDICARE: SWARUPA K NAIDU
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
1103T00000XPsychologist30880TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130880OTHERTXSTATELICENSE

General Provider Information

NPI Number : 1841390663
Entity Type Code : Individual
Provider Name (Legal Business Name) : SWARUPA K NAIDU
Provider Business Mailing Address
First Line : 605 E 4TH ST
Second Line : SUITE 300
City : ODESSA
State : TX
Zip : 79761-5100
Country : US
Telephone Number : 432-337-4347
Fax Number : 432-337-1657
Provider Business Practice Location Address
First Line : 605 E 4TH ST
Second Line : SUITE 300
City : ODESSA
State : TX
Zip : 79761-5100
Country : US
Telephone Number : 432-337-4347
Fax Number : 432-337-1657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 07/08/2007

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Directions to “ SWARUPA K NAIDU ” Practice Location

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