Organization
GADAM M. RAO,MD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GADAM M RAO MD (PHYSICIAN)
(940) 761-2229
Entity
Organization
Contact information
Practice address
1718 10TH STREET, WICHITA FALLS, TX 76301
(940) 761-2229
(940) 761-2220
Mailing address
PO BOX 4289, WICHITA FALLS, TX 76308
(940) 761-2229
(940) 761-2220
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K1634
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048AR
BLUE CROSS BLUE SHIELD
TX
05
—
092131401
—
TX
05
—
092131402
—
TX
01
—
8AJ053
BCBS
TX
Enumeration date
10/03/2006
Last updated
11/02/2011
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