Provider Demographics
NPI:1467542431
Name:KUMARAPILLAI NARENDRAN MD PA
Entity Type:Organization
Organization Name:KUMARAPILLAI NARENDRAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-795-5561
Mailing Address - Street 1:3712 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1312
Mailing Address - Country:US
Mailing Address - Phone:806-795-5561
Mailing Address - Fax:806-687-7792
Practice Address - Street 1:3712 22ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1312
Practice Address - Country:US
Practice Address - Phone:806-795-5561
Practice Address - Fax:806-687-7792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3564207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0067BAOtherBLUE CROSS BLUE SHIELD
TX148066702Medicaid
TXC19779Medicare UPIN
TX00573RMedicare PIN