Provider Demographics
NPI:1700071008
Name:NARMALA, SHRAVAN KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SHRAVAN
Middle Name:KUMAR
Last Name:NARMALA
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2250
Mailing Address - Fax:956-362-2251
Practice Address - Street 1:2717 MICHAELANGELO DR STE 200
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1412
Practice Address - Country:US
Practice Address - Phone:956-362-2250
Practice Address - Fax:956-362-2251
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017037295207RH0003X
NMMD2014-0044207RX0202X
MS24239207RX0202X
390200000X
TXQ7247207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1006394Medicaid