Provider Demographics
NPI:1619397072
Name:TELUKUNTLA, KARTIK SAINAG
Entity Type:Individual
Prefix:
First Name:KARTIK
Middle Name:SAINAG
Last Name:TELUKUNTLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 WALNUT HILL LN STE 700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3824
Mailing Address - Country:US
Mailing Address - Phone:214-361-3300
Mailing Address - Fax:
Practice Address - Street 1:8440 WALNUT HILL LN STE 700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3824
Practice Address - Country:US
Practice Address - Phone:214-361-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS9807207RC0000X, 207RA0001X
PAMT205959390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program