Organization
BOPANNA MUCKATIRA MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOPANNA MUCKATIRA MD (PHYSICIAN)
(325) 670-6900
Entity
Organization
Contact information
Practice address
1025 CYPRESS ST, ABILENE, TX 79601-4117
(325) 670-6900
(325) 670-6905
Mailing address
1025 CYPRESS ST, ABILENE, TX 79601-4117
(325) 670-6900
(325) 670-6905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059 NA
BCBS
TX
05
—
1795775-01
—
TX
Enumeration date
10/21/2008
Last updated
12/17/2025
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