Provider Demographics
NPI:1710140843
Name:PALADUGU, GOPIKRISHNA (MD)
Entity type:Individual
Prefix:
First Name:GOPIKRISHNA
Middle Name:
Last Name:PALADUGU
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 1:4401 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2122
Mailing Address - Country:US
Mailing Address - Phone:832-556-6351
Mailing Address - Fax:713-799-9598
Practice Address - Street 1:4401 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2122
Practice Address - Country:US
Practice Address - Phone:832-556-6351
Practice Address - Fax:713-799-9598
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXW0080208M00000X
390200000X
ND11921208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND15927Medicaid
NDN716723Medicare PIN
NDN717265Medicare PIN