Healthcare Provider Details

I. General information

NPI: 1093010878
Provider Name (Legal Business Name): RUPESH NIGAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 E COMMON ST
NEW BRAUNFELS TX
78130-6059
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 830-730-8580
  • Fax: 830-327-1021
Mailing address:
  • Phone: 830-730-5025
  • Fax: 830-730-4207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberP0643
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberP0643
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP0643
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: