Individual
KUMARA S PEDDAMATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1601 MAIN ST, STE 401, RICHMOND, TX 77469-3244
(281) 342-9530
(281) 342-9564
Mailing address
1601 MAIN ST, STE 401, RICHMOND, TX 77469-3244
(713) 459-4326
(281) 903-5002
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G4378
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G84F
BCBS
TX
05
—
098552501
—
TX
05
—
098552503
—
TX
01
—
8CM672
BCBS
TX
Enumeration date
06/24/2005
Last updated
08/14/2011
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