Individual provider

Supraja Gulla, MD

Internal Medicine Physician Hospitalist Physician

Supraja Gulla, MD is an Internal Medicine Physician in Georgetown, TX, registered under NPI 1104076389. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 4945 WILLIAMS DR, Georgetown, TX 78633. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

4945 WILLIAMS DR, Georgetown, TX 78633 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
T4929 TX Internal Medicine Physician primary
125.054210 IL Internal Medicine Physician
01069786A IN Internal Medicine Physician
01069786A IN Hospitalist Physician

Licences are recorded in 3 states: TX, IL, IN. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)

This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.

Licensed in 3 states

This provider holds licences in 3 states: Illinois, Indiana and Texas. The practice address on file is in Georgetown, TX, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

IL Illinois
Licence
125.054210
Specialty
Internal Medicine Physician
Verify with the IL board →
IN Indiana
Licence
01069786A
Specialty
Internal Medicine Physician
Verify with the IN board →
TX Texas practice address
Licence
T4929
Specialty
Internal Medicine Physician
Verify with the TX board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Internal Medicine covers

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NUCC Health Care Provider Taxonomy, code 207R00000X
Allopathic & Osteopathic Physicians Internal Medicine

All registered taxonomy codes

This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
207R00000X Internal Medicine Physician T4929 TX primary
207R00000X Internal Medicine Physician 125.054210 IL
207R00000X Internal Medicine Physician 01069786A IN
208M00000X Hospitalist Physician 01069786A IN

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104076389 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateSep 24, 2008
Last updatedJul 27, 2023
StatusActive
Sole proprietorNo
CredentialMD
Practice address 4945 WILLIAMS DR
Georgetown, TX 78633
(317) 962-2894
Mailing address PO BOX 844658
Dallas, TX 75284
Other identifiers 201037090 (IN)
The last update on file is Jul 27, 2023. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1104076389 passes the NPI check digit test The final digit 9 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 0 7 6 3 8
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 0 7 3 3 7

Sum = 51 · next multiple of 10 = 60 · check digit = 9 · actual last digit = 9

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104076389?
NPI 1104076389 is the National Provider Identifier assigned to Supraja Gulla, MD in Georgetown, TX. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Internal Medicine Physician cover?
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive…
How do I contact Supraja Gulla, MD?
The phone number on file with NPPES is (317) 962-2894, last updated Jul 27, 2023. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Is NPI 1104076389 a valid number?
Yes. 1104076389 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.