Organization Active NPI

Vasudeva Reddy Boosupalli MD PA

  • Neurology with Special Qualifications in Child Neurology Physician
  • Webster, TX
National Provider Identifier
1902907512
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
M3475 Issued in TX
Legal business name
VASUDEVA REDDY BOOSUPALLI MD PA
Practice address
131 W Texas Ave
Webster, TX 77598-3203
Phone
(281) 481-0002
Fax
(281) 481-0007
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Dr. Vasudeva Reddy Boosupalli, MD
Title
President
Phone
(281) 481-0002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0402X M3475 TX Primary

Addresses

Primary practice location

131 W Texas Ave
Webster, TX 77598-3203

Mailing address

131 W Texas Ave
Webster, TX 77598-3203
Phone (281) 481-0002

Other names 1

  • Bay Area Child Neurology Doing business as

National Provider Directory

National Provider Directory

Locations

11920 Astoria Blvd
Ste 290
Houston, TX 77089
Phone (281) 464-3757

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1902907512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W TEXAS AVE",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775983203",
            "telephone_number": "281-481-0002",
            "fax_number": "281-481-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W TEXAS AVE",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775983203",
            "telephone_number": "281-481-0002",
            "fax_number": "281-481-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASUDEVA REDDY BOOSUPALLI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "BOOSUPALLI",
        "authorized_official_first_name": "VASUDEVA",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-481-0002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "M3475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Area Child Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.