MEDICARE: DR. LAKSHMI SWARNA PUPPALA 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	207Q00000X	Family Medicine Physician	N1082	TX
2	207R00000X	Internal Medicine Physician	N1082	TX
3	208M00000X	Hospitalist Physician	N1082	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8FT361	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1477755510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAKSHMI SWARNA PUPPALA MD

Provider Business Mailing Address
First Line	:	5110 BUFFALO SPEEDWAY
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77005-4218
Country	:	US
Telephone Number	:	713-363-7460
Fax Number	:	281-660-0706

Provider Business Practice Location Address
First Line	:	5110 BUFFALO SPEEDWAY
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77005-4218
Country	:	US
Telephone Number	:	713-363-7460
Fax Number	:	281-660-0706

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

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	09/19/2024

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