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General NPI Number Information
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NPI Number | 1174204127
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Entity Type | Organization
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Legal Business Name | MERITMD OF TEXAS LLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 3600 S LOOP 340
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City | ROBINSON
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State | TX
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Zip | 76706-4828
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Country | US
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Telephone | 972-693-8634
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 540088
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City | HOUSTON
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State | TX
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Zip | 77254-0088
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | USHA BANGALORE KRISHNAPPA
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Credential | MD
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Telephone | 972-693-8634
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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