Provider Demographics
NPI:1386223022
Name:VANAPALA, PRAGNA (MD)
Entity Type:Individual
Prefix:
First Name:PRAGNA
Middle Name:
Last Name:VANAPALA
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 1:5675 LAKE DISTRICT DR UNIT 206
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4463
Mailing Address - Country:US
Mailing Address - Phone:703-582-4164
Mailing Address - Fax:
Practice Address - Street 1:5675 LAKE DISTRICT DR UNIT 206
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-4463
Practice Address - Country:US
Practice Address - Phone:703-582-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program