Basic Information
| Provider Information | |||||||||
| NPI: | 1669835401 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VARAKANTAM | ||||||||
| FirstName: | SWAPNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1015 LOUISE DR | ||||||||
| Address2: | |||||||||
| City: | NEDERLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 776276813 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8585 PICARDY AVE | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708093679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257634000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2016 | ||||||||
| LastUpdateDate: | 08/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 27857 | MS | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.