Provider Demographics
NPI:1710086640
Name:GUTTIKONDA, LAKSHMI V (MD)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:V
Last Name:GUTTIKONDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAKSHMI
Other - Middle Name:V
Other - Last Name:PARUCHURI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4503 BORDEAUX PLACE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502
Mailing Address - Country:US
Mailing Address - Phone:254-778-2107
Mailing Address - Fax:
Practice Address - Street 1:4503 BORDEAUX PLACE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502
Practice Address - Country:US
Practice Address - Phone:254-778-2107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1911208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation