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NPI Code Detail

MEDICARE: DR. KANTHI YALAMANCHILI M.D.

MEDICARE: DR. KANTHI YALAMANCHILI M.D.
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
1207RG0100XGastroenterology PhysicianL9562TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18CW400OTHERTXBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821290651
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KANTHI YALAMANCHILI M.D.
Provider Business Mailing Address
First Line : PO BOX 35629
Second Line :
City : DALLAS
State : TX
Zip : 75235-0629
Country : US
Telephone Number : 214-424-2200
Fax Number : 214-231-2159
Provider Business Practice Location Address
First Line : 4370 MEDICAL ARTS DR STE 295
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-1742
Country : US
Telephone Number : 972-691-3777
Fax Number : 972-691-3666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 02/01/2024

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