MEDICARE: UTTAM TRIPATHY MD

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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	M2846	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8G5886	OTHER	TX	BCBS
2	04865986	OTHER		ECFMG
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144285966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UTTAM TRIPATHY MD

Provider Business Mailing Address
First Line	:	P O BOX 540088
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77254
Country	:	US
Telephone Number	:	713-850-1190
Fax Number	:	713-850-1327

Provider Business Practice Location Address
First Line	:	16605 SOUTHWEST FWY
Second Line	:	SUITE 575 MOB 3
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3501
Country	:	US
Telephone Number	:	281-232-1908
Fax Number	:	281-232-1914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	06/01/2016

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Directions to “ UTTAM TRIPATHY MD” Practice Location

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