Individual
GURUPRASAD TIPTUR MAHADEVAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3030
Mailing address
315 N SAN SABA STE 1135, SAN ANTONIO, TX 78207-3255
(210) 704-8878
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
A152729
CA
2080P0202X
Pediatric Cardiology Physician
Primary
V1910
TX
2080P0203X
Pediatric Critical Care Medicine Physician
A152729
CA
2080P0203X
Pediatric Critical Care Medicine Physician
V1910
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14901846
—
NM
Enumeration date
11/03/2009
Last updated
09/03/2024
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