Basic Information
| Provider Information | |||||||||
| NPI: | 1891052825 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MADHAVARAPU | ||||||||
| FirstName: | SUMITH | ||||||||
| MiddleName: | RAO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1317 ISABELLA ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770044037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054740683 | ||||||||
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| Practice Location | |||||||||
| Address1: | 921 GESSNER RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7132423000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2012 | ||||||||
| LastUpdateDate: | 07/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 54230 | CT | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080S0012X | R7266 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | Sleep Medicine | 208000000X | R7266 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.