Provider Demographics
NPI:1275572117
Name:TALWALKAR, NIRUPAMA (MD)
Entity Type:Individual
Prefix:
First Name:NIRUPAMA
Middle Name:
Last Name:TALWALKAR
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 1:3843 PENBROOK ST
Mailing Address - Street 2:# 52
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-6152
Mailing Address - Country:US
Mailing Address - Phone:432-368-4167
Mailing Address - Fax:432-368-4167
Practice Address - Street 1:3001 W ILLINOIS AVE
Practice Address - Street 2:SUITE 3B1
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3180
Practice Address - Country:US
Practice Address - Phone:432-296-2180
Practice Address - Fax:432-368-4167
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3494208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8V1200OtherBLUE CROSS BLUE SHIELD
TXH73871Medicare UPIN
TX8F2455Medicare ID - Type Unspecified