Provider Demographics
NPI:1568543221
Name:ANNAPUREDDY, KARUNAKAR R (MD)
Entity Type:Individual
Prefix:
First Name:KARUNAKAR
Middle Name:R
Last Name:ANNAPUREDDY
Suffix:
Gender:M
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:PO BOX 201706
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78720-1706
Mailing Address - Country:US
Mailing Address - Phone:512-306-8696
Mailing Address - Fax:512-292-4458
Practice Address - Street 1:919 E 32ND ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2703
Practice Address - Country:US
Practice Address - Phone:512-544-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3972207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031174802Medicaid
110229408OtherRAILROAD MEDICARE
00810GOtherBLUE CROSS BLUE SHIELD
TX031174802Medicaid
110229408OtherRAILROAD MEDICARE
TX00415TMedicare PIN