Healthcare Provider Details

I. General information

NPI: 1356409437
Provider Name (Legal Business Name): MADHAVA SETHU ABBURI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 N MOPAC EXPY STE 420
AUSTIN TX
78731-3055
US

IV. Provider business mailing address

7000 N MOPAC EXPY STE 420
AUSTIN TX
78731-3055
US

V. Phone/Fax

Practice location:
  • Phone: 512-482-0045
  • Fax: 512-476-9892
Mailing address:
  • Phone: 512-482-0045
  • Fax: 512-476-9892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number43784020
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN3412
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36303
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE-12394
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberSP-158
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: