Provider Demographics
NPI:1831967058
Name:DR NIRMALA TUMARADA LLC
Entity type:Organization
Organization Name:DR NIRMALA TUMARADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMARADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-585-7930
Mailing Address - Street 1:6438 WHITE OLEANDER CIR E
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-0377
Mailing Address - Country:US
Mailing Address - Phone:205-585-7930
Mailing Address - Fax:
Practice Address - Street 1:707 DR MICHAEL DEBAKEY DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5728
Practice Address - Country:US
Practice Address - Phone:374-333-0762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty