Mary Vikram Udyavar, AGACNP

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

1090350 Issued in TX

Practice address

23306 Ivory Sedge TRL
Katy, TX 77493-1178

Phone

(346) 381-9496

NPI assigned

Aug 22, 2022

Last updated

Aug 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Integrative Primary Care PLLC

  • Internal Medicine Physician
  • Katy, TX
  • NPI 1710377346

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1932827268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23306 IVORY SEDGE TRL",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774931178",
            "telephone_number": "346-381-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23306 IVORY SEDGE TRL",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774931178",
            "telephone_number": "346-381-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDYAVAR",
        "first_name": "MARY",
        "middle_name": "VIKRAM",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "1090350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ihuoma Uko Udeh
• Sharanya Udipi, PH.D., L.P.
• Lucy Aniefon Udofia, COTA/L
• Perpetua Ekwutosi Udom
• Jesse Uduma, DO
• Nkeiruka Ugwu
• Evelyn Ambo Ugwuzor, PHARM.D, PH.D
• Fredrick Uhlman, OTA
• Ifeoma Ukachukwu, NP
• Ult Psychiatry Services LLC

• Critical Care Medicine (Internal Medicine) Physician in Katy, TX
• Providers in Katy, TX by specialty
• Critical Care Medicine (Internal Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.