Individual
BABU HOSAKOTE SUBRAHMANYAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
717 MAGNOLIA ST, JACKSBORO, TX 76458-1111
(940) 567-6633
Mailing address
717 MAGNOLIA ST, JACKSBORO, TX 76458-1111
(940) 567-6633
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34839
OK
207Q00000X
Family Medicine Physician
N7433
TX
Other
Enumeration date
12/04/2007
Last updated
04/15/2021
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