Individual
RAKESH SURAPANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 UNIVERSITY BLVD BLDG A, ROUND ROCK, TX 78665-1032
(512) 509-0100
(512) 509-2137
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
P3589
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121352
MASSHEALTH
—
01
—
A40016
MEDICARE
MA
01
—
J40419
BLUE CROSS
—
Enumeration date
03/29/2006
Last updated
11/06/2020
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