Provider Demographics
NPI:1447441068
Name:VALLABHANENI, APARNA (MD)
Entity type:Individual
Prefix:DR
First Name:APARNA
Middle Name:
Last Name:VALLABHANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 W WILLIAM CANNON DR STE 112
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5322
Mailing Address - Country:US
Mailing Address - Phone:512-444-2661
Mailing Address - Fax:512-444-2720
Practice Address - Street 1:1901 W WILLIAM CANNON DR STE 112
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5322
Practice Address - Country:US
Practice Address - Phone:512-444-2661
Practice Address - Fax:512-444-2720
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2081207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX428968YLPSOtherWELLMED PTAN
TX347788701Medicaid