Provider Demographics
NPI:1295764181
Name:INAGANTI, KASTURI (MD)
Entity type:Individual
Prefix:DR
First Name:KASTURI
Middle Name:
Last Name:INAGANTI
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 1:601 CLARA BARTON BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5738
Mailing Address - Country:US
Mailing Address - Phone:972-494-6235
Mailing Address - Fax:972-272-2073
Practice Address - Street 1:601 CLARA BARTON BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5738
Practice Address - Country:US
Practice Address - Phone:972-494-6235
Practice Address - Fax:972-272-2073
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4462207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00190335OtherRR MEDICARE
TX1702052-01Medicaid
TX8C9846Medicare ID - Type Unspecified
TXI22935Medicare UPIN