Basic Information
| Provider Information | |||||||||
| NPI: | 1720059488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BADIGA | ||||||||
| FirstName: | S | ||||||||
| MiddleName: | MURTHY | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BADIGA | ||||||||
| OtherFirstName: | SRIRAMACHANDRA | ||||||||
| OtherMiddleName: | MURTHY | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 6139 | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785026139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563622171 | ||||||||
| FaxNumber: | 9563622699 | ||||||||
| Practice Location | |||||||||
| Address1: | 902 S AIRPORT DR | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | WESLACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785966644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563623636 | ||||||||
| FaxNumber: | 9563622699 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2006 | ||||||||
| LastUpdateDate: | 01/20/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | J5254 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 110701306 | 05 | TX | MEDICAID | 110701305 | 05 | TX | MEDICAID |