MEDICARE: DR. SOWMYA NANJAPPA 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	207RI0200X	Infectious Disease Physician	30918	WV
2	207RI0200X	Infectious Disease Physician	0101269105	VA
3	207RI0200X	Infectious Disease Physician	TM2022-0111	NM
4	207RI0200X	Infectious Disease Physician	2020-00720	NC
5	207RI0200X	Infectious Disease Physician	S4198	TX

General Provider Information

NPI Number	:	1942565403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOWMYA NANJAPPA MD

Provider Business Mailing Address
First Line	:	4100 W 15TH ST STE 110
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-5826
Country	:	US
Telephone Number	:	469-408-9558
Fax Number	:	888-393-5922

Provider Business Practice Location Address
First Line	:	4100 W 15TH ST STE 110
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-5826
Country	:	US
Telephone Number	:	469-408-9558
Fax Number	:	888-393-5922

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

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	04/28/2025

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