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NPI Code Detail

MEDICARE: MADHURI GUDIPATY M.D

MEDICARE: MADHURI GUDIPATY M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianN5087TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10N40170OTHERMIMEDICARE GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
216-0636544-2OTHERMIBCBS PIN NUMBER
3700E012740OTHERMIBCBS GROUP NUMBER
4700E012740OTHERMIBCBS

General Provider Information

NPI Number : 1073731683
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADHURI GUDIPATY M.D
Provider Business Mailing Address
First Line : 5953 DALLAS PKWY STE 200A
Second Line :
City : PLANO
State : TX
Zip : 75093-8189
Country : US
Telephone Number : 972-867-7500
Fax Number : 972-578-7550
Provider Business Practice Location Address
First Line : 5953 DALLAS PKWY STE 200A
Second Line :
City : PLANO
State : TX
Zip : 75093-8189
Country : US
Telephone Number : 972-867-7500
Fax Number : 972-578-7550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2007
Last Update Date : 05/20/2025

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