Healthy Living Primary Care PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

HEALTHY LIVING PRIMARY CARE PLLC

Practice address

200 S Rivershire Dr Ste 200
Conroe, TX 77304-3485

Phone

(936) 234-5400

Fax

(888) 714-0097

NPI assigned

Apr 16, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tapasya Mandalapu, MD

Title

Managing Director

Phone

(786) 449-6644

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1114547486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S RIVERSHIRE DR STE 200",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043485",
            "telephone_number": "936-234-5400",
            "fax_number": "888-714-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S RIVERSHIRE DR STE 200",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043485",
            "telephone_number": "936-234-5400",
            "fax_number": "888-714-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "MANDALAPU",
        "authorized_official_first_name": "TAPASYA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "786-449-6644",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.