Provider Demographics
NPI:1033410162
Name:MALUCHURU, RADHA KRISHNA (RCS,RVS)
Entity Type:Individual
Prefix:
First Name:RADHA
Middle Name:KRISHNA
Last Name:MALUCHURU
Suffix:
Gender:F
Credentials:RCS,RVS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 HIDDEN RDG
Mailing Address - Street 2:APT#2028
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-7911
Mailing Address - Country:US
Mailing Address - Phone:972-900-2839
Mailing Address - Fax:
Practice Address - Street 1:1107 HIDDEN RDG
Practice Address - Street 2:APT#2028
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-7911
Practice Address - Country:US
Practice Address - Phone:972-900-2839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00072030246W00000X, 246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
No246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology