Provider Demographics
NPI:1457518268
Name:YENIGALLA, USHA KIRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:KIRAN
Last Name:YENIGALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:USHA
Other - Middle Name:KIRAN
Other - Last Name:YENIGALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12221 MERIT DR.
Mailing Address - Street 2:STE 1500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2202
Mailing Address - Country:US
Mailing Address - Phone:214-217-1991
Mailing Address - Fax:214-217-1912
Practice Address - Street 1:SHADY GROVE ADVENTIST MEDICAL CENTER
Practice Address - Street 2:9901 MEDICAL CENTER DR
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4729
Practice Address - Country:US
Practice Address - Phone:630-926-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD71323207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine