Provider Demographics
NPI:1477755510
Name:PUPPALA, LAKSHMI SWARNA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:SWARNA
Last Name:PUPPALA
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 1:5110 BUFFALO SPEEDWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4218
Mailing Address - Country:US
Mailing Address - Phone:713-363-7460
Mailing Address - Fax:281-660-0706
Practice Address - Street 1:5110 BUFFALO SPEEDWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4218
Practice Address - Country:US
Practice Address - Phone:713-363-7460
Practice Address - Fax:281-660-0706
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1082207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FT361OtherBLUE CROSS BLUE SHIELD
TX198188802Medicaid
TX198188803Medicaid
TX8FT361OtherBLUE CROSS BLUE SHIELD
TX198188803Medicaid
TX320463ZSWDMedicare PIN