Individual
DR. SHANTI NULU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 SETON PKWY STE 302, ROUND ROCK, TX 78665-8003
(512) 324-4812
(512) 324-4728
Mailing address
301 SETON PARKWAY, SUITE 302, ROUND ROCK, TX 78665
(512) 324-4812
(512) 324-4728
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
Q6251
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
580601YL9X
MEDICARE
TX
01
—
580601YMGJ
MEDICARE
TX
01
—
8GV735
BCBS
TX
Enumeration date
09/20/2007
Last updated
07/21/2022
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