Individual provider Active NPI

Radha Kumari Paruchuri, MD

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1265634554
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N1042 Issued in TX
Practice address
1740 Hidden Brook Dr
Grand Prairie, TX 75050-8334
Phone
(817) 937-4084
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N1042 TX Primary

Addresses

Primary practice location

1740 Hidden Brook Dr
Grand Prairie, TX 75050-8334

Mailing address

1740 Hidden Brook Dr
Grand Prairie, TX 75050-8334
Phone (817) 937-4084

Other identifiers 1

IdentifierTypeStateIssuer
BP1-0026110OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090914000613 TX Practitioner - Family Practice 2466508635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N1042TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group PA CurrentSince Sep 9, 2013 Accepting new patients
Primamed Physicians PLLC Past Accepting new patients
Primamed Physicians PLLC PastSince Feb 9, 2025 Accepting new patients

Locations

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1265634554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 HIDDEN BROOK DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750508334",
            "telephone_number": "817-937-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 HIDDEN BROOK DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750508334",
            "telephone_number": "817-937-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARUCHURI",
        "first_name": "RADHA",
        "middle_name": "KUMARI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026110",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.