Individual
BOPANNA MUCKATIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 CYPRESS ST, ABILENE, TX 79601-4117
(325) 670-6900
(325) 670-6905
Mailing address
1904 PINE ST, STE 1 E, ABILENE, TX 79601-2449
(325) 670-6900
(325) 670-6905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301065426
MI
207R00000X
Internal Medicine Physician
Primary
L4072
TX
208M00000X
Hospitalist Physician
4301065426
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059NA
BCBSTX
TX
05
—
1795775-01
—
TX
01
—
BM065426
BCBSM
MI
Enumeration date
06/20/2005
Last updated
12/17/2025
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