Individual
ATUL POUDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4102 24TH ST STE 303, LUBBOCK, TX 79410-1802
(806) 725-8395
(806) 723-7005
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
S7316
TX
2080P0210X
Pediatric Nephrology Physician
S7316
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447674858
BCBS NM
NM
05
—
1447674858
—
TX
05
—
27022242
—
NM
01
—
2I6403
MEDICARE
TX
01
—
8SL700
BCBS
TX
Enumeration date
02/06/2014
Last updated
02/01/2024
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