Individual
MURALI VATHADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 NOLA RUTH BLVD, HARKER HEIGHTS, TX 76548-6074
(877) 800-5722
(254) 238-9294
Mailing address
205 E UNIVERSITY AVE, SUITE 200, GEORGETOWN, TX 78626-6814
(512) 868-1124
(512) 868-9894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
040270
GA
208000000X
Pediatrics Physician
Primary
N5454
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000670271
—
GA
Enumeration date
05/16/2006
Last updated
10/12/2017
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