Bommanna, Vasudeva M
Bommanna, Vasudeva M is an sole proprietor health care provider with primary practice located at 607 Russell Blvd Suite ' B', Nacogdoches TX 75965-1247. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Bommanna, Vasudeva M can be contacted via phone (936) 559-7750.Contact Information
Primary practice address
607 Russell Blvd Suite ' B'
Nacogdoches TX 75965-1247
Phone: (936) 559-7750
Fax: (936) 559-7807
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | K 3685 | Texas |
| Allopathic & Osteopathic Physicians / Allergy | 207KA0200X | K 3685 | Texas |
Profile Details
| NPI number | 1477594836 |
|---|---|
| LBN Legal business name | Bommanna, Vasudeva M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Jul 16th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477594836 | NPPES |
| Texas | Other | 612574 | MEDICARE # FOR WEBSTER |
| Texas | Other | 0020CF | MEDICARE # FOR WEBSTER |
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