Provider Demographics
NPI:1568085397
Name:KALATHURU, SOWMYA (DO)
Entity Type:Individual
Prefix:
First Name:SOWMYA
Middle Name:
Last Name:KALATHURU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4438 CENTERVIEW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1440
Mailing Address - Country:US
Mailing Address - Phone:210-280-0040
Mailing Address - Fax:210-280-0060
Practice Address - Street 1:4438 CENTERVIEW
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1440
Practice Address - Country:US
Practice Address - Phone:210-280-0040
Practice Address - Fax:210-280-0060
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT3797208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice