Organization
B. C. MUTHAPPA, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BACHARANIANDA CHENGAPPA MUTHAPPA M.D. (PRESIDENT)
(903) 427-2201
Entity
Organization
Contact information
Practice address
120 FARM ROAD 2825, CLARKSVILLE, TX 75426-3348
(903) 427-2201
Mailing address
120 FARM ROAD 2825, P O BOX 1429, CLARKSVILLE, TX 75426-3348
(903) 427-2201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F0268
TX
208600000X
Surgery Physician
F0268
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000BN34
BCBS PROVIDER #
TX
05
—
1225203-04
—
TX
Enumeration date
10/31/2006
Last updated
10/06/2011
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