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General NPI Number Information
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NPI Number | 1073892519
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Entity Type | Organization
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Legal Business Name | MANOHAR YEDULAPURAM MD PA
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 7501 VALLEEN DR
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City | PLANO
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State | TX
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Zip | 75024-3977
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Country | US
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Telephone | 972-618-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 VALLEEN DR
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City | PLANO
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State | TX
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Zip | 75024-3977
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Country | US
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Telephone | 972-618-1020
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Fax |
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Authorized Official
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Title or Position | HOSPITALIST
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Name | MANOHAR YEDULAPURAM
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Credential | M.D
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Telephone | 972-618-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | M1411
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License Number State | TX
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