Provider Demographics
NPI:1073551115
Name:SEGU, VENKATESH BABU G (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKATESH BABU
Middle Name:G
Last Name:SEGU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 MEDICAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7875
Mailing Address - Country:US
Mailing Address - Phone:512-765-7806
Mailing Address - Fax:512-456-7039
Practice Address - Street 1:1515 MEDICAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7875
Practice Address - Country:US
Practice Address - Phone:512-765-7806
Practice Address - Fax:512-456-7039
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8849207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CU727OtherBCBSTX
TXTXB131276Medicare PIN
IN499500GGGGMedicare PIN
ING 86329Medicare UPIN
TXTXB131278Medicare PIN