Provider Demographics
NPI:1154509230
Name:UPPALAPATI, SESHA S (MD)
Entity Type:Individual
Prefix:
First Name:SESHA
Middle Name:S
Last Name:UPPALAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 GOLDEN TRIANGLE BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4483
Mailing Address - Country:US
Mailing Address - Phone:817-310-8881
Mailing Address - Fax:855-227-7491
Practice Address - Street 1:4901 GOLDEN TRIANGLE BLVD STE 121
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4483
Practice Address - Country:US
Practice Address - Phone:817-310-8881
Practice Address - Fax:855-227-7491
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8467207R00000X, 207RE0101X
PAMD432585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX283355005Medicaid
TX283355006OtherMEDICAID - OTHER
TX336133YL7AOtherMEDICARE - OTHER COUNTY
TXTXB147343Medicare PIN
TX283355006OtherMEDICAID - OTHER
TX283355005Medicaid
TXTXB147337Medicare PIN