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Individual

DR. MADHAVILATHA VUPPALI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
200 S RIVERSHIRE DR STE 300, CONROE, TX 77304-3485
(832) 610-2822
(936) 777-8831
Mailing address
200 S RIVERSHIRE DR STE 300, CONROE, TX 77304-3485
(832) 610-2822
(936) 777-8831

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N4825
TX
207RN0300X
Nephrology Physician
Primary
N4825
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
209330403
TX
Enumeration date
02/11/2008
Last updated
06/29/2022
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