Healthcare Provider Details

I. General information

NPI: 1568722312
Provider Name (Legal Business Name): PRIYANKA KAMATH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6204 BALCONES DR
AUSTIN TX
78731-4214
US

IV. Provider business mailing address

PO BOX 911230
DALLAS TX
75391-1230
US

V. Phone/Fax

Practice location:
  • Phone: 512-427-9400
  • Fax: 512-427-9436
Mailing address:
  • Phone: 972-997-8000
  • Fax: 305-243-4938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME127974
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberBP10042801
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberS6652
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberS6652
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: