Healthcare Provider Details

I. General information

NPI: 1821243171
Provider Name (Legal Business Name): DR. YOUGANDHAR AKULA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2008
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 E VILLA MARIA RD
BRYAN TX
77802-2542
US

IV. Provider business mailing address

2110 E VILLA MARIA RD
BRYAN TX
77802-2542
US

V. Phone/Fax

Practice location:
  • Phone: 979-822-5555
  • Fax:
Mailing address:
  • Phone: 979-822-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberR4176
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.204037
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: