| Bopanna Muckatira Md, Pa | |
|
1904 Pine St 1 E Abilene TX 79601-2449 | |
| (325) 670-6900 | |
| (325) 670-6905 |
| Full Name | Bopanna Muckatira Md, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1904 Pine St, Abilene, Texas |
| Authorized Official Name and Position | Bopanna Muckatira (PHYSICIAN) |
| Authorized Official Contact | 3256706900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bopanna Muckatira Md, Pa 1904 Pine St 1 E Abilene TX 79601-2449 Ph: (325) 670-6900 | Bopanna Muckatira Md, Pa 1904 Pine St 1 E Abilene TX 79601-2449 Ph: (325) 670-6900 |
| NPI Number | 1922250059 |
|---|---|
| Provider Enumeration Date | 10/21/2008 |
| Last Update Date | 09/25/2024 |
| Medicare PECOS PAC ID | 4880743731 |
|---|---|
| Medicare Enrollment ID | O20090522000403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922250059 | NPI | - | NPPES |
| 0059 NA | Other | TX | BCBS |
| 1795775-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Bopanna Muckatira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114922713 PECOS PAC ID: 3971537283 Enrollment ID: I20051116000696 |
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