Provider Demographics
NPI:1457358731
Name:KUMARASHEKHARA, VARUNI H (DPM)
Entity type:Individual
Prefix:
First Name:VARUNI
Middle Name:H
Last Name:KUMARASHEKHARA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 PANDALE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2628
Mailing Address - Country:US
Mailing Address - Phone:210-865-4406
Mailing Address - Fax:
Practice Address - Street 1:5704 PANDALE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2628
Practice Address - Country:US
Practice Address - Phone:210-865-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1703P213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176367401Medicaid
TX4986670022OtherPALMETTO GBA
TX8J1314OtherBCBS
TX7107646OtherAETNA
TXP00303299OtherMEDICARE RAILROAD
TX200850300OtherDEPARTMENT OF LABOR
TXP00303299OtherMEDICARE RAILROAD
TX8J1314OtherBCBS