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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114922713 NPPES
Texas Other 0059NA BCBSTX
Texas MEDICAID 1795775-01 BCBSTX
Texas Other BM065426 BCBSTX

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