Individual
SAMBASIVA RAO MARUPUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 QUAIL CREEK DRIVE, SUITE #103, AMARILLO, TX 79124-1634
(806) 358-7911
(806) 358-9600
Mailing address
800 QUAIL CREEK DRIVE, SUITE #103, AMARILLO, TX 79124-1634
(806) 358-7911
(806) 358-9600
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
G4168
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097428903
—
TX
01
—
4018116
AETNA INS CO
—
01
—
8K8370
BCBS
TX
01
—
P00125078
RR MEDICARE
—
Enumeration date
07/02/2006
Last updated
01/06/2014
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