Organization
AMARILLO COLON AND RECTAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMBASIVA RAO MARUPUDI MD (PRESIDENT)
(806) 358-7911
Entity
Organization
Contact information
Practice address
800 QUAIL CREEK DRIVE, SUITE 103, AMARILLO, TX 79124-1634
(806) 358-7911
(806) 358-9600
Mailing address
800 QUAIL CREEK DRIVE, SUITE 103, AMARILLO, TX 79124-1634
(806) 358-7911
(806) 358-9600
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007KZ
BLUE CROSS BLUE SHIELD
TX
01
—
7330374
AETNA INS CO
—
01
—
DB7392
RAILROAD MEDICARE
—
Enumeration date
07/31/2006
Last updated
08/22/2020
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