Individual
ANNAPURNA JAGARLAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6100 HARRIS PKWY, FORT WORTH, TX 76132-4101
(817) 820-4906
(817) 820-4815
Mailing address
6100 HARRIS PKWY, FORT WORTH, TX 76132-4101
(817) 820-4906
(817) 820-4815
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23403
WV
207R00000X
Internal Medicine Physician
35.087715
OH
207R00000X
Internal Medicine Physician
Primary
P5087
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210223
OH MEDICAID UNISON
OH
01
—
001875984
MOUNTAIN STATE BCBS
—
01
—
2687758
OH MEDICAID MOLINA
OH
05
—
2687758
—
OH
01
—
310917085173
OH MEDICAID CARESOURCE
OH
05
—
3810005849
—
WV
01
—
P00363725
RR MEDICARE
—
Enumeration date
07/04/2006
Last updated
05/22/2013
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