Provider Demographics
NPI:1801113790
Name:KAMADA, PRATIMA (MD)
Entity type:Individual
Prefix:DR
First Name:PRATIMA
Middle Name:
Last Name:KAMADA
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 1:12221 N MOPAC EXPY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2401
Mailing Address - Country:US
Mailing Address - Phone:512-901-4937
Mailing Address - Fax:
Practice Address - Street 1:1711 S COLORADO ST STE C
Practice Address - Street 2:
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644-4616
Practice Address - Country:US
Practice Address - Phone:512-805-0680
Practice Address - Fax:512-805-0682
Is Sole Proprietor?:No
Enumeration Date:2010-05-01
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0036664207R00000X
IA42684207RN0300X
WI64216207RN0300X
MN25694207RN0300X
TXT1404207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine