Provider Demographics
NPI:1235340290
Name:MEKALA, DURGA PRASAD (MD)
Entity Type:Individual
Prefix:
First Name:DURGA
Middle Name:PRASAD
Last Name:MEKALA
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 1:3132 MATLOCK RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2910
Mailing Address - Country:US
Mailing Address - Phone:817-987-1414
Mailing Address - Fax:814-987-1425
Practice Address - Street 1:3132 MATLOCK RD
Practice Address - Street 2:SUITE 311
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2910
Practice Address - Country:US
Practice Address - Phone:817-987-1414
Practice Address - Fax:817-987-1425
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116018184207Q00000X
TXN8039207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine