Provider Demographics
NPI:1912966391
Name:VEMULA, NARASIMHARAO (MD)
Entity Type:Individual
Prefix:DR
First Name:NARASIMHARAO
Middle Name:
Last Name:VEMULA
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 1:7610 N STEMMONS FWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4231
Mailing Address - Country:US
Mailing Address - Phone:214-689-5960
Mailing Address - Fax:469-713-8084
Practice Address - Street 1:1900 BLUEGRASS AVE STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1183
Practice Address - Country:US
Practice Address - Phone:502-895-8970
Practice Address - Fax:502-897-8971
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0573207RG0100X
KY53133207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A7892OtherBCBSTX
TX140890801Medicaid
TX81505KMedicare PIN
TX8A7892OtherBCBSTX
TX100014841Medicare PIN