Provider Demographics
NPI:1013957273
Name:RAO, KAMALA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALA
Middle Name:
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAMALA
Other - Middle Name:
Other - Last Name:RAMAKRISHNARAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 691786
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78269-1786
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:234 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1103
Practice Address - Country:US
Practice Address - Phone:210-224-2424
Practice Address - Fax:210-224-2040
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMDF8625207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134817901Medicaid
TX8U6220OtherBLUE CROSS ID #
00NB21Medicare PIN
TX8U6220OtherBLUE CROSS ID #