Provider Demographics
NPI:1013395086
Name:CHUNDURU, MEDHA (MD)
Entity Type:Individual
Prefix:
First Name:MEDHA
Middle Name:
Last Name:CHUNDURU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 S STAPLES ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3113
Mailing Address - Country:US
Mailing Address - Phone:361-694-1498
Mailing Address - Fax:361-694-1499
Practice Address - Street 1:1521 S STAPLES ST STE 300
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3113
Practice Address - Country:US
Practice Address - Phone:361-694-1498
Practice Address - Fax:361-694-1499
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT8511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine