Organization
VENKAT NAMBURU MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKAT ESWARA-RAO NAMBURU M.D. (PRESIDENT)
(817) 386-5767
Entity
Organization
Contact information
Practice address
7633 BELLAIRE DR S, SUITE 105, FORT WORTH, TX 76132-4311
(817) 386-5767
(817) 386-5857
Mailing address
7633 BELLAIRE DR S, SUITE 105, FORT WORTH, TX 76132-4311
(817) 386-5767
(817) 386-5857
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
L3766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181455001
—
TX
Enumeration date
10/03/2005
Last updated
10/06/2017
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