Provider Demographics
NPI:1104417435
Name:MDCH PARTNERS LLC
Entity type:Organization
Organization Name:MDCH PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVI KANTH
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:YALAMURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-834-7649
Mailing Address - Street 1:5718 UNIVERSAL HTS BLVD
Mailing Address - Street 2:STE 203A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249
Mailing Address - Country:US
Mailing Address - Phone:210-834-7649
Mailing Address - Fax:833-422-0139
Practice Address - Street 1:5718 UNIVERSAL HTS BLVD
Practice Address - Street 2:STE 203A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249
Practice Address - Country:US
Practice Address - Phone:210-834-7649
Practice Address - Fax:833-422-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP4132OtherMD LICENSE