Provider Demographics
NPI:1982791463
Name:SOLIPURAM, ARUN KUMAR REDDY (MD)
Entity type:Individual
Prefix:
First Name:ARUN KUMAR
Middle Name:REDDY
Last Name:SOLIPURAM
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 1:13023 ORCHARD GLEN DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3204
Mailing Address - Country:US
Mailing Address - Phone:281-537-4393
Mailing Address - Fax:281-715-4576
Practice Address - Street 1:13023 ORCHARD GLEN DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3204
Practice Address - Country:US
Practice Address - Phone:281-537-4393
Practice Address - Fax:281-715-4576
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26232207RG0300X
TXN4120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR028357Medicaid
ID807513000Medicaid
1505102OtherPACIFIC SOURCE
930830668OtherGROUP TAX ID
I51178Medicare UPIN
134399Medicare ID - Type Unspecified