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NPI Code Detail

MEDICARE: DR. ABHINAV VEMULA M.D.

MEDICARE: DR. ABHINAV VEMULA 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
1207RG0100XGastroenterology PhysicianS4410TX

General Provider Information

NPI Number : 1508109281
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABHINAV VEMULA M.D.
Provider Business Mailing Address
First Line : 4370 MEDICAL ARTS DR STE 295
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-1742
Country : US
Telephone Number : 377-797-2691
Fax Number :
Provider Business Practice Location Address
First Line : 4370 MEDICAL ARTS DR STE 295
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-1742
Country : US
Telephone Number : 377-797-2691
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2013
Last Update Date : 05/28/2020

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