P Praxis·MD
● Active Type 1 · Individual

Supraja R. Gulla, MD

Internal Medicine·Georgetown, TX· NPI 1104076389 · Enumerated 2008 · 17 years on NPI
Gulla is 1 of 39 internal medicine providers in Georgetown and 1 of 12343 in Texas.
NPI age
17 years
Enumerated 2008-09-24
Primary specialty
Internal Medicine
Plus 3 subspecialties
Licensed in
TX, IL, IN
3 states
Status
Active
No deactivations on record
Last NPPES update
2023-07-27
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 12343 active internal medicine providers in Texas.

NPI age
17 years
≈ at median (17 yr)
State licenses
3 states
Top 88% — 12% of peers are multi-state
Subspecialties
1
In the 33% of peers with subspecialties

NPI lifetime · 2008 → 2026

2008-09Enumerated in NPPES
2008 2026

Where they practice

Practice location
4945 Williams Dr
Georgetown, TX 786332008
📞 3179622894
Mailing address
Po Box 844658
Dallas, TX 752844658

Specialties

  • Internal Medicine Primary
    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,...
    TX license #T4929IL license #125.054210IN license #01069786A taxonomy 207R00000X
  • Hospitalist
    Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term...
    IN license #01069786A taxonomy 208M00000X

Identifiers

TypeValueNotes
05 (IN) 201037090
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.

Practice context

Part of a multi-provider practice. 45 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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