Provider Demographics
NPI:1821276064
Name:MRUDULA DESHPANDE
Entity Type:Organization
Organization Name:MRUDULA DESHPANDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MRUDULA
Authorized Official - Middle Name:ABHAY
Authorized Official - Last Name:DESHPANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-250-0406
Mailing Address - Street 1:13740 RESEARCH BLVD
Mailing Address - Street 2:BLDG. V-1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1884
Mailing Address - Country:US
Mailing Address - Phone:512-250-0406
Mailing Address - Fax:512-250-0531
Practice Address - Street 1:13740 RESEARCH BLVD
Practice Address - Street 2:BLDG. V-1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1884
Practice Address - Country:US
Practice Address - Phone:512-250-0406
Practice Address - Fax:512-250-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8078208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty