Provider Demographics
NPI:1841645181
Name:GODIGAMUWA, KUMARI K (MD)
Entity type:Individual
Prefix:DR
First Name:KUMARI
Middle Name:K
Last Name:GODIGAMUWA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6210 E HIGHWAY 290 STE 420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-231-5545
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:4515 SETON CENTER PKWY STE 220
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5784
Practice Address - Country:US
Practice Address - Phone:512-338-8388
Practice Address - Fax:512-406-6247
Is Sole Proprietor?:No
Enumeration Date:2016-04-23
Last Update Date:2020-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXS5628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine