Basic Information
| Provider Information | |||||||||
| NPI: | 1639803943 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | USN CIRCLE OF CARE, P.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 W RIO SALADO PKWY STE 201 | ||||||||
| Address2: | |||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852813812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806106100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13656 BRETON RIDGE ST UNIT A&H | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770706081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814298780 | ||||||||
| FaxNumber: | 2817637930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2022 | ||||||||
| LastUpdateDate: | 07/12/2022 | ||||||||
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| AuthorizedOfficialLastName: | MUNIKRISHNAPPA | ||||||||
| AuthorizedOfficialFirstName: | DEVARAJ | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7135983040 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.