Provider Demographics
NPI:1194822304
Name:KATYAL, TULIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:TULIKA
Middle Name:
Last Name:KATYAL
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 1:10024 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1829
Mailing Address - Country:US
Mailing Address - Phone:314-919-2500
Mailing Address - Fax:314-919-2577
Practice Address - Street 1:10024 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1829
Practice Address - Country:US
Practice Address - Phone:314-919-2500
Practice Address - Fax:314-919-2577
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003002313207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000090481Medicare ID - Type Unspecified
H90190Medicare UPIN