Provider Demographics
NPI:1003077892
Name:KADAKIA, RUPALI RAJAN (MD)
Entity Type:Individual
Prefix:
First Name:RUPALI
Middle Name:RAJAN
Last Name:KADAKIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUPALI
Other - Middle Name:NARENDRA
Other - Last Name:JOSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8520 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7716
Mailing Address - Country:US
Mailing Address - Phone:281-485-4050
Mailing Address - Fax:
Practice Address - Street 1:8520 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7716
Practice Address - Country:US
Practice Address - Phone:281-485-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX334862502Medicaid