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General NPI Number Information
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NPI Number | 1740397397
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Entity Type | Individual
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Provider Name | SYAM S VEMULAPALLI MD
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 315 E 5TH ST
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City | ODESSA
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State | TX
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Zip | 79761-5133
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Country | US
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Telephone | 432-333-3433
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Fax | 432-333-3450
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Provider Business Mailing Address
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Address Line | 315 E 5TH ST
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City | ODESSA
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State | TX
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Zip | 79761-5133
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Country | US
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Telephone | 432-333-3433
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Fax | 432-333-3450
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | M6440
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License Number State | TX
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