Muckatira, Bopanna
Muckatira, Bopanna is an sole proprietor health care provider with primary practice located at 1904 Pine St Ste 1 E, Abilene TX 79601-2449. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Muckatira, Bopanna can be contacted via phone (325) 670-6900.Contact Information
Primary practice address
1904 Pine St Ste 1 E
Abilene TX 79601-2449
Phone: (325) 670-6900
Fax: (325) 670-6905
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301065426 | Michigan |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 4301065426 | Michigan |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | L4072 | Texas |
Profile Details
| NPI number | 1114922713 |
|---|---|
| LBN Legal business name | Muckatira, Bopanna |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 20th, 2005 |
| Last updated | May 1st, 2014 - about 10 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 | 1114922713 | NPPES |
| Texas | Other | 0059NA | BCBSTX |
| Texas | MEDICAID | 1795775-01 | BCBSTX |
| Texas | Other | BM065426 | BCBSTX |
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