Provider Demographics
NPI:1295547172
Name:GURRAM, ANURADHA (FNP-C)
Entity type:Individual
Prefix:
First Name:ANURADHA
Middle Name:
Last Name:GURRAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4955 USAA BLVD UNIT 9
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1785
Mailing Address - Country:US
Mailing Address - Phone:469-265-2108
Mailing Address - Fax:
Practice Address - Street 1:10423 STATE HIGHWAY 151 STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4767
Practice Address - Country:US
Practice Address - Phone:210-876-1451
Practice Address - Fax:210-876-1761
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1182278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily