Individual
DR. MACHAIAH M MADHRIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2228
(817) 877-5858
(817) 335-4418
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 877-5858
(817) 335-4418
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q5219
TX
207RN0300X
Nephrology Physician
41806
AZ
207RN0300X
Nephrology Physician
Primary
Q5219
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350469801
—
TX
05
—
421797
—
AZ
Enumeration date
04/16/2009
Last updated
09/02/2022
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