Healthcare Provider Details

I. General information

NPI: 1588625735
Provider Name (Legal Business Name): SANKARARAO TAMTAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 STATE HIGHWAY 46 W STE 1201
NEW BRAUNFELS TX
78132-5393
US

IV. Provider business mailing address

425 W COLONIAL DR STE 303
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 830-730-4125
  • Fax: 830-312-7896
Mailing address:
  • Phone: 830-730-5025
  • Fax: 830-730-4207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK7628
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: