Provider Demographics
NPI:1750323002
Name:LAKSHMI, KONDAPAVULURU (MD)
Entity Type:Individual
Prefix:DR
First Name:KONDAPAVULURU
Middle Name:
Last Name:LAKSHMI
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 1:7410 W EXPWY 83
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-9527
Mailing Address - Country:US
Mailing Address - Phone:956-585-2010
Mailing Address - Fax:956-584-8460
Practice Address - Street 1:7410 W EXPWY 83
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-9527
Practice Address - Country:US
Practice Address - Phone:956-585-2010
Practice Address - Fax:956-584-8460
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84040NMedicare ID - Type UnspecifiedMEDICARE
TXC18099Medicare UPIN