Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | N8849 | TX |
NPI | 1073551115 |
---|---|
Provider Name | Dr. Venkatesh Babu G. Segu |
First Address | Cedar Park, TX 78613-7875 |
Second Address | Cedar Park, TX 78613-7875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 01/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8CU727 | BCBSTX (01) | TX |
G 86329 | (02) | IN |