Provider Demographics
NPI:1336661545
Name:VARDE, SAMRITA UDAY (MD)
Entity Type:Individual
Prefix:
First Name:SAMRITA
Middle Name:UDAY
Last Name:VARDE
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 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:832-709-2770
Mailing Address - Fax:
Practice Address - Street 1:DEDICATED PHYSICIANS GROUP OF TEXAS PLLC
Practice Address - Street 2:8471 GULF FREEWAY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-5001
Practice Address - Country:US
Practice Address - Phone:832-709-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2522207Q00000X
MI4301500777207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine