MANJULA MUDDULURU (NPI# 1184741852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184741852 |
| Entity Type | Individual |
| Full Name | MANJULA MUDDULURU |
| Credential | MD |
| Practice Address |
701 W 5th St Odessa TX 79763 |
| Mailing Address |
701 W 5th St Ste 3142 Odessa TX 79763-4206 |
| Practice Telephone | 4327035310 |
| Practice Fax Number | 4323355354 |
| Mailing Telephone | 4327035310 |
| Mailing Fax Number | 4323355354 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2018-06-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Q3243 | TX | Allopathic & Osteopathic Physicians |
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Q3243 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
701 W 5TH ST |
| City | ODESSA |
| State | TX |
| Zip Code | 79763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407845084 | Texas Tech University Health Sciences Center Odessa | Internal Medicine | 701 W 5th St, Odessa, TX 79763-4206 | 2005-10-17 |
| 1568075117 | Bibek Bakhati | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-08-24 |
| 1972112852 | Priya Darshini Velumani | Internal Medicine | 701 W 5th St, Odessa, TX 79763-4206 | 2020-07-28 |
| 1811505274 | Hina Tariq | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-07-21 |
| 1710595350 | Prince Richardson Lemuel Ernest | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-07-20 |
| 1952939951 | Goutami Mangu | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2020-03-27 |
| 1790337483 | Mandeep Kaur Sidhu | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-07-12 |
| 1174185292 | Andrey Mironenko | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-06-29 |
| 1043872120 | Govind Jha | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-06-28 |
| 1447811682 | Juan Guillermo Sierra David | Student in an Organized Health Care Education/Training Program | 701 W 5th St, Odessa, TX 79763-4206 | 2019-06-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164885 | Mary Ewusie | Pharmacist | 2450 West Loop 3378, Odessa, TX 79763 | 2020-11-03 |
| 1982231569 | Yashica Patel | Student in an Organized Health Care Education/Training Program | 701 W. 5th St, Suite 1229, Odessa, TX 79763 | 2020-03-24 |
| 1144740457 | Devi Priya Suravajjala | Student in an Organized Health Care Education/Training Program | 701,w 5th Street, Odessa, TX 79763 | 2017-06-27 |
| 1649640392 | Elesea Celeste Villegas | Physician Assistant | 701 West 5th Street, Odessa, TX 79763 | 2015-10-06 |
| 1790046472 | Kathryn Nichole Hutton | Obstetrics & Gynecology | 701 W 5th Street, Odessa, TX 79763 | 2012-05-30 |
| 1962761791 | Marvin Ryan Harvey | Family Medicine | 701 W 5th St Ste 3174, Odessa, TX 79763 | 2012-05-14 |
| 1245529544 | Yvette Garcia | Counselor | 1012 W Macarthur, Odessa, TX 79763 | 2011-04-07 |
| 1386973873 | Patty Denise Pena | Pharmacist | 1305 W County Rd, Odessa, TX 79763 | 2009-12-14 |
| 1508002262 | Javier E Espinoza | Physician Assistant | 1220 W. University, Odessa, TX 79763 | 2008-12-31 |
| 1952584690 | J A Mayans Md Pa | Ophthalmology | 907 W Second St, Odessa, TX 79763 | 2007-12-17 |
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| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881793909 | Durga K Annavajjhala | Pediatrics | 6 Santa Elena Ct, Odessa, TX 79765-8503 | 2006-09-22 |
| 1861495368 | Deborah L Pickens | Pediatrics | 701 W. 5th Street, Suite 3142, Odessa, TX 79763 | 2005-05-27 |
| 1811304801 | Visalakshi Sethuraman | Pediatrics | 701 W 5th St Ste 3142, Odessa, TX 79763-4206 | 2014-07-22 |
| 1497886535 | Anthony Lyle Talbert | Pediatrics | 701 W 5th St, Odessa, TX 79763-4206 | 2007-03-08 |
| 1013047919 | Carlos Nieto Jr. | Pediatrics | 701 W 5th St, Odessa, TX 79763-4206 | 2007-03-07 |
| 1164578613 | Raul Chavez Valdez | Pediatrics | 701 W 5th St, Odessa, TX 79763-4206 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699233510 | Allison Claire Arbilo | Pediatrics | 6431 Fannin St # 3.254, Houston, TX 77030-1501 | 2019-03-10 |
| 1619469343 | Deulofeut Physician Services Pllc | Pediatrics | 1924 Pine St Ste 401b, Abilene, TX 79601-2452 | 2018-05-30 |
| 1801303979 | Gulf Coast Neonatology, Pllc | Pediatrics | 5920 Saratoga Blvd Ste 450, Corpus Christi, TX 78414-4124 | 2018-01-10 |
| 1023522331 | Richard Michael Rodriguez | Pediatrics | 2205 Concord Pl, Brownsville, TX 78520-3984 | 2017-11-22 |
| 1306266200 | Carlos A Laos, Md, Pa | Pediatrics | 25 Cochran Oaks Ln, Dallas, TX 75220-7811 | 2014-04-18 |
| 1225451032 | Sherlene Annette Dreyer | Pediatrics | 5000 Montrose Blvd Unit 19b, Houston, TX 77006-6564 | 2014-01-29 |
| 1154752418 | Dolores Carruth | Pediatrics | 2510 Skyline Dr, Irving, TX 75038-5819 | 2013-12-11 |
| 1891033981 | Lisa Jensen Mitchell | Pediatrics | Carl R. Darnall Medical Center, 2608 Marlin Dr, Killeen, TX 76543-2773 | 2013-01-23 |
| 1780940940 | Harashada Luhar | Pediatrics | 4707 Circle Oak Cv, Austin, TX 78749-2302 | 2012-04-02 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.