MEDICARE: DR. VENKATA A VALLURY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	H 7241	TX
2	207Q00000X	Family Medicine Physician	H7241	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356346241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VENKATA A VALLURY MD

Provider Business Mailing Address
First Line	:	700 N PEARL ST STE N510
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-2863
Country	:	US
Telephone Number	:	214-580-7277
Fax Number	:	214-999-9363

Provider Business Practice Location Address
First Line	:	13000 JOSEY LN STE 100
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-3669
Country	:	US
Telephone Number	:	972-791-8029
Fax Number	:	214-999-9363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/10/2023

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