Provider Demographics
NPI:1679678460
Name:ARUMUGHAM, PALANIAPPAN (MD)
Entity type:Individual
Prefix:
First Name:PALANIAPPAN
Middle Name:
Last Name:ARUMUGHAM
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 1:399 W CAMPBELL RD STE 412
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3636
Mailing Address - Country:US
Mailing Address - Phone:972-669-1454
Mailing Address - Fax:972-690-0567
Practice Address - Street 1:399 W CAMPBELL RD STE 412
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3636
Practice Address - Country:US
Practice Address - Phone:972-669-1454
Practice Address - Fax:972-690-0567
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4992207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032311501Medicaid
C12981Medicare UPIN
TX032311501Medicaid