Provider Demographics
NPI:1235105784
Name:VANGALA, KARUNA R (MD)
Entity Type:Individual
Prefix:DR
First Name:KARUNA
Middle Name:R
Last Name:VANGALA
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 1:420 N HIGHWAY 67 STE D1
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6069
Mailing Address - Country:US
Mailing Address - Phone:972-291-7181
Mailing Address - Fax:972-291-0687
Practice Address - Street 1:420 N HIGHWAY 67 STE D1
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-6069
Practice Address - Country:US
Practice Address - Phone:972-291-7181
Practice Address - Fax:972-291-0687
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4692207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB27256Medicare UPIN
TX8C1822Medicare PIN