Provider Demographics
NPI:1447374699
Name:MADAPPA, TARUN (MD)
Entity type:Individual
Prefix:DR
First Name:TARUN
Middle Name:
Last Name:MADAPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3109
Mailing Address - Country:US
Mailing Address - Phone:361-884-2687
Mailing Address - Fax:361-884-3425
Practice Address - Street 1:1501 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3109
Practice Address - Country:US
Practice Address - Phone:361-884-2687
Practice Address - Fax:361-884-3425
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP-53223207R00000X
IN01066012A207RP1001X, 207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN227950F7Medicare PIN