Provider Demographics
NPI:1679037089
Name:S&C HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:S&C HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VASUDEVA
Authorized Official - Middle Name:RANJIT
Authorized Official - Last Name:MUDIPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-542-8566
Mailing Address - Street 1:PO BOX 780188
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-0188
Mailing Address - Country:US
Mailing Address - Phone:830-542-8566
Mailing Address - Fax:210-802-2620
Practice Address - Street 1:11212 TX-151
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:830-542-8566
Practice Address - Fax:210-802-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34938001OtherDRIVERS LICENSE