Provider Demographics
NPI:1912101585
Name:KANDALA, RANGANATH NONESUPPLIED (MD)
Entity Type:Individual
Prefix:DR
First Name:RANGANATH
Middle Name:NONESUPPLIED
Last Name:KANDALA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3519 TOWN CENTER BLVD S
Mailing Address - Street 2:STE B
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1001
Mailing Address - Country:US
Mailing Address - Phone:832-771-2601
Mailing Address - Fax:281-213-0169
Practice Address - Street 1:4545 POST OAK PLACE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3164
Practice Address - Country:US
Practice Address - Phone:713-960-8008
Practice Address - Fax:713-960-0965
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY7726A208M00000X
TXM8070207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3899556410OtherMYUTMB 3899556410-COMMERCIAL NUMBER