Individual
DR. BACHARANIANDA CHENGAPPA MUTHAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.R.C.S.
Contact information
Practice address
120 FARM ROAD 2825, CLARKSVILLE, TX 75426-3348
(903) 427-2201
(903) 427-3204
Mailing address
120 FARM ROAD 2825, P O BOX 1429, CLARKSVILLE, TX 75426-3348
(903) 427-2201
(903) 427-3204
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 NUMBER
TX
05
—
1225203-04
—
TX
Enumeration date
10/12/2006
Last updated
11/29/2011
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