Provider Demographics
NPI:1952303489
Name:BILOLIKAR, VARSHA SURESH (MD)
Entity Type:Individual
Prefix:DR
First Name:VARSHA
Middle Name:SURESH
Last Name:BILOLIKAR
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 1:1705 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2709
Mailing Address - Country:US
Mailing Address - Phone:512-978-8400
Mailing Address - Fax:512-901-9726
Practice Address - Street 1:1705 E 11TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702
Practice Address - Country:US
Practice Address - Phone:512-978-8400
Practice Address - Fax:512-901-9726
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076775207Q00000X
IL036117361207Q00000X
TXR2815207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MII01232Medicare UPIN
IL834330001Medicare PIN
MII01232Medicare UPIN
IL834330001Medicare PIN
IL834330OtherMEDICARE GROUP #
MI4601546Medicaid
IL834330001Medicare PIN
ILP00670264/CC5050OtherRAIL ROAD MEDICARE GROUP/MEMBER PTAN
IL834330OtherMEDICARE GROUP #
MIM75620074Medicare ID - Type Unspecified
ILK36355Medicare ID - Type Unspecified
ILK36354Medicare ID - Type Unspecified
IL553180Medicare ID - Type UnspecifiedMEDICARE GROUP #