Provider Demographics
NPI:1508050949
Name:PALADUGU, KANAKA DURGA (MD)
Entity Type:Individual
Prefix:
First Name:KANAKA
Middle Name:DURGA
Last Name:PALADUGU
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:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-0223
Mailing Address - Country:US
Mailing Address - Phone:512-321-3948
Mailing Address - Fax:
Practice Address - Street 1:605 NE 9TH ST
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TX
Practice Address - Zip Code:78957-1025
Practice Address - Country:US
Practice Address - Phone:512-237-2411
Practice Address - Fax:512-237-4833
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8232207Q00000X
VA0101242344207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine