Provider Demographics
NPI:1215477823
Name:MURTHY GEDALA PLLC
Entity type:Organization
Organization Name:MURTHY GEDALA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MURTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEDALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-374-2929
Mailing Address - Street 1:PO BOX 782467
Mailing Address - Street 2:12951 HUEBNER RD
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-2467
Mailing Address - Country:US
Mailing Address - Phone:210-374-2929
Mailing Address - Fax:210-802-2620
Practice Address - Street 1:111 DALLAS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1201
Practice Address - Country:US
Practice Address - Phone:210-297-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1697207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty