1538489810 NPI number — SRI VENKATA UPPALAPATI M.B.B.S., MD

NPI Number: 1538489810
Health Care Provider/Practitioner: SRI VENKATA UPPALAPATI M.B.B.S., MD

NPI Number : 1538489810 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538489810",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "UPPALAPATI",
    "FirstName": "SRI",
    "MiddleName": "VENKATA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.B.B.S., MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "655 LOUISE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRVIEW",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75069-9421",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "918-852-9062",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4664 AMERICAN AVE STE B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BAKERSFIELD",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93309-4017",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-800-9155",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/09/2010",
    "LastUpdateDate": "03/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "4301105192",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "R6305",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "C170376",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}