Provider Demographics
NPI:1982603593
Name:KUNDA, KOTESWARA RAO (MD)
Entity Type:Individual
Prefix:
First Name:KOTESWARA
Middle Name:RAO
Last Name:KUNDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MEDICAL PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7580
Mailing Address - Country:US
Mailing Address - Phone:512-396-3545
Mailing Address - Fax:512-396-1349
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7580
Practice Address - Country:US
Practice Address - Phone:512-396-3545
Practice Address - Fax:512-396-1349
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3367207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG03838Medicare UPIN
TX8902B9Medicare ID - Type Unspecified