Provider Demographics
NPI:1689993297
Name:MUKKARA SIVA, RAMA KRISHNA REDDY (MD)
Entity Type:Individual
Prefix:
First Name:RAMA KRISHNA
Middle Name:REDDY
Last Name:MUKKARA SIVA
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 1:6949 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3911
Mailing Address - Country:US
Mailing Address - Phone:361-251-7650
Mailing Address - Fax:
Practice Address - Street 1:805 MORGAN AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2025
Practice Address - Country:US
Practice Address - Phone:361-251-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2647208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist