Individual
SUBRAHMAN R BOYAREDDIGARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 SW 25TH AVE, MINERAL WELLS, TX 76067-8246
(940) 328-1771
(940) 325-4440
Mailing address
PO BOX 578, MINERAL WELLS, TX 76068-0578
(940) 328-1771
(940) 325-4440
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G6476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1138414-02
—
TX
Enumeration date
07/07/2006
Last updated
03/19/2025
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