Individual
DR. MADHAVI RUDRARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8201 EWING HALSELL DR, 2ND FLOOR, SAN ANTONIO, TX 78229-3707
(210) 575-8514
(210) 575-8004
Mailing address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 575-8514
(210) 575-8004
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
N5374
TX
207RI0008X
Hepatology Physician
N5374
TX
207RT0003X
Transplant Hepatology Physician
Primary
N5374
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219652901
—
TX
01
—
219652902
CSHCN
TX
01
—
8CJ296
BCBS
TX
01
—
P00996225
MEDICARE RAILROAD
—
Enumeration date
06/26/2006
Last updated
02/24/2017
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