MEDICARE: DR. PRAMODA KUMAR MOHAPATRA 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
1	207Q00000X	Family Medicine Physician	L7280	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3410037-01	OTHER	TX	TPI HEALTH POINT HEMPSTEAD
3	L7280	OTHER	TX	STATE LICENSE
4	1649689274	OTHER	TX	HEALTH POINT HEMPSTEAD - FACILITY NPI
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1821185299	OTHER	TX	BVCAA, INC. - AGENCY NPI
7	74-1868	OTHER	TX	PTAN HEALTH POINT HEMPSTEAD

General Provider Information

NPI Number	:	1447237243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRAMODA KUMAR MOHAPATRA M.D.

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 FM 1488 ROAD
Second Line	:	HEALTH POINT HEMPSTEAD
City	:	HEMPSTEAD
State	:	TX
Zip	:	77445-9998
Country	:	US
Telephone Number	:	979-826-8200
Fax Number	:	979-826-8210

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	02/24/2025

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Directions to “ DR. PRAMODA KUMAR MOHAPATRA M.D.” Practice Location

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