Provider Demographics
NPI:1093010878
Name:NIGAM, RUPESH (MD)
Entity type:Individual
Prefix:
First Name:RUPESH
Middle Name:
Last Name:NIGAM
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 1:1770 STATE HIGHWAY 46 W STE 1201
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-5393
Mailing Address - Country:US
Mailing Address - Phone:830-730-5025
Mailing Address - Fax:830-730-4207
Practice Address - Street 1:1762 E COMMON ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6059
Practice Address - Country:US
Practice Address - Phone:830-730-8580
Practice Address - Fax:830-327-1021
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0643208M00000X, 207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX284239503Medicaid
TX284239502Medicaid
TX284239501Medicaid
TXTXB134147Medicare PIN
TX284239502Medicaid
TX284239503Medicaid