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Individual

VIJAY JAMPALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2407 S CLEAR CREEK RD, KILLEEN, TX 76549
(254) 628-0246
(254) 200-4090
Mailing address
PO BOX 938, KILLEEN, TX 76540-0938
(254) 634-6999
(254) 200-4099

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
H4970
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00D65L
BLUE CROSS BLUE SHIELD
TX
01
097895901
SUPERIOR HEALTH CHIPS
TX
05
097895901
TX
01
742533636
HUMANA/MILITARY-TRICARE
TX
01
90017
SCOTT & WHITE HEALTH
TX
01
P00080993
MEDICARE RAILROAD
TX
Enumeration date
11/29/2005
Last updated
07/11/2008
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