Provider Demographics
NPI:1669795506
Name:SURAPANENI, VAMSI K (MD)
Entity type:Individual
Prefix:DR
First Name:VAMSI
Middle Name:K
Last Name:SURAPANENI
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 1:3333 RESEARCH PLAZA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235
Mailing Address - Country:US
Mailing Address - Phone:210-297-3011
Mailing Address - Fax:210-297-0352
Practice Address - Street 1:3333 RESEARCH PLAZA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235
Practice Address - Country:US
Practice Address - Phone:210-297-3011
Practice Address - Fax:210-297-0352
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine