Provider Demographics
NPI:1265634554
Name:PARUCHURI, RADHA KUMARI (MD)
Entity Type:Individual
Prefix:DR
First Name:RADHA
Middle Name:KUMARI
Last Name:PARUCHURI
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 1:1740 HIDDEN BROOK DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-8334
Mailing Address - Country:US
Mailing Address - Phone:817-937-4084
Mailing Address - Fax:
Practice Address - Street 1:1740 HIDDEN BROOK DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-8334
Practice Address - Country:US
Practice Address - Phone:817-937-4084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0026110OtherINSTITUTIONAL PERMIT