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NPI Code Detail

MEDICARE: DR. BHASKARA M PONNURU MD

MEDICARE: DR. BHASKARA M PONNURU 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
1207L00000XAnesthesiology PhysicianF8619TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275634388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BHASKARA M PONNURU MD
Provider Business Mailing Address
First Line : 1002 GEMINI ST STE 128
Second Line :
City : HOUSTON
State : TX
Zip : 77058-2746
Country : US
Telephone Number : 281-218-9515
Fax Number :
Provider Business Practice Location Address
First Line : 1002 GEMINI ST STE 128
Second Line :
City : HOUSTON
State : TX
Zip : 77058-2746
Country : US
Telephone Number : 281-218-9515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 11/16/2016

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Directions to “ DR. BHASKARA M PONNURU MD” Practice Location

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