Provider Demographics
NPI:1386609188
Name:PACHIPALA, KRISHNA K (MD)
Entity type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:K
Last Name:PACHIPALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KRISHNA
Other - Middle Name:K
Other - Last Name:PACHIPALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:17323 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1243
Mailing Address - Country:US
Mailing Address - Phone:281-440-5006
Mailing Address - Fax:
Practice Address - Street 1:17323 RED OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1243
Practice Address - Country:US
Practice Address - Phone:281-440-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6815207RH0003X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00779061Medicare PIN
H80877Medicare UPIN
TX8L17866Medicare PIN
TX0533800001Medicare NSC
TX1386609188Medicare PIN
TX8J9217Medicare PIN
PA068547Medicare ID - Type Unspecified