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General NPI Number Information
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NPI Number | 1477119873
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Entity Type | Individual
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Provider Name | APARNA KANUPARTHY
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Gender | Female
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 7551 YOUREE DR STE 11
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City | SHREVEPORT
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State | LA
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Zip | 71105-5533
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Country | US
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Telephone | 318-642-9282
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Fax |
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Provider Business Mailing Address
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Address Line | 105 QUINCE WAY
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City | LONGVIEW
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State | TX
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Zip | 75605-7759
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Country | US
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Telephone | 903-238-1602
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 334161
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10068789
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License Number State | TX
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