MEDICARE: SAVITA R KURUP 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	MD61367487	WA
2	207Q00000X	Family Medicine Physician	L2394	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568457968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVITA R KURUP MD

Provider Business Mailing Address
First Line	:	12417 BELLA VINO DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76126-4929
Country	:	US
Telephone Number	:	817-239-1071
Fax Number	:	817-782-9468

Provider Business Practice Location Address
First Line	:	6100 HARRIS PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4101
Country	:	US
Telephone Number	:	817-433-5977
Fax Number	:	817-433-5989

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	04/29/2025

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Directions to “ SAVITA R KURUP MD” Practice Location

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