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Individual

SRIDHAR NARRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3708 JEFFERSON ST, STE A, AUSTIN, TX 78731-6206
(512) 459-6503
(512) 454-7453
Mailing address
3708 JEFFERSON ST, STE A, AUSTIN, TX 78731-6206
(512) 459-6503
(512) 454-7453

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301074999
MI
208M00000X
Hospitalist Physician
Primary
N1401
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104437440
MI
05
443744010
MI
01
5237621
LEGACY
01
5315009871
PHARMACY LIC
MI
01
TXB150302
WELLMED MEDICAL GROUP PA
01
TXB155615
WELLMED NETWORKS INC
TX
01
TXB155615
WELLMED NETWORKS INC
Enumeration date
02/13/2006
Last updated
07/17/2015
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