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Individual

DR. KUMUD S TRIPATHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2215 E VILLA MARIA RD, #110, BRYAN, TX 77802-2548
(979) 776-2000
(979) 776-0427
Mailing address
2215 E VILLA MARIA RD, #110, BRYAN, TX 77802-2548
(979) 776-2000
(979) 776-0427

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
F9046
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100005101
TX
01
110135938
MEDICARE RAILROAD
TX
01
125738100
FIRST CARE
TX
Enumeration date
05/16/2006
Last updated
09/20/2007
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