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DR. SUDHIR MADISETTY M.D. NPI 1588672760


NPI Information

NPI: 1588672760
Provider Name: DR. SUDHIR MADISETTY, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 45D2020008

Address:
1607 LAKE SUCCESS DR
WACO, TX
ZIP 76710
Phone: (254) 772-0783
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DR. Sudhir Madisetty, M.D. is a pediatrics in Waco, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Sudhir Madisetty, M.D. NPI is 1588672760. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1607 LAKE SUCCESS DR
WACO, TX
ZIP 76710-908
Phone: (254) 772-0783
Fax: (254) 772-1463

The CLIA number assigned to this NPI record is 45D2020008 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/4/2006 and was last updated on 8/21/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistJ3846TEXASNo
2208000000XPediatricsJ3846TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1118342100OTHERTEXASFIRSTCARE
2092053001MEDICAIDTEXAS
38A9340OTHERTEXASBLUECROSSBLUESHIELD
4121348OTHERTEXASSUPERIOR
5092053002MEDICAIDTEXAS
6E64019MEDICARE UPINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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