NPIMap

Organization Active NPI

Nandan Kumar Puvvada

  • Surgery Physician
  • Palestine, TX
National Provider Identifier
1487773859
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M5002 Issued in TX
Legal business name
NANDAN KUMAR PUVVADA
Practice address
4002 S Loop 256
Suite L
Palestine, TX 75801-8491
Phone
(903) 723-0033
Fax
(903) 723-0036
NPI assigned
Mar 28, 2007
Last updated
Oct 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Authorized official

Name
Nandan K Puvvada, M.D.NPI 1083797823
Title
Sole Proprietor
Phone
(903) 723-0033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X M5002 TX Primary

Addresses

Primary practice location

4002 S Loop 256
Suite L
Palestine, TX 75801-8491

Mailing address

4002 S Loop 256
Suite L
Palestine, TX 75801-8491
Phone (903) 723-0033

National Provider Directory

National Provider Directory

Locations

4002 S Loop 256
Ste L
Palestine, TX 75801
Phone (903) 723-0033

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1487773859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 S LOOP 256",
            "address_2": "SUITE L",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018491",
            "telephone_number": "903-723-0033",
            "fax_number": "903-723-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 S LOOP 256",
            "address_2": "SUITE L",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018491",
            "telephone_number": "903-723-0033",
            "fax_number": "903-723-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANDAN KUMAR PUVVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "PUVVADA",
        "authorized_official_first_name": "NANDAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "903-723-0033",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "M5002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.