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General NPI Number Information
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NPI Number | 1033307368
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Entity Type | Organization
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Legal Business Name | PHASES OF LIFE WOMENS HEALTH CARE, PA
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 7999 WEST VIRGINIA SUITE A
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City | DALLAS
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State | TX
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Zip | 75237-2041
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Country | US
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Telephone | 972-296-4777
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Fax | 972-296-5499
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Provider Business Mailing Address
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Address Line | 7999 WEST VIRGINIA DR SUITE A
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City | DALLAS
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State | TX
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Zip | 75237-2041
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Country | US
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Telephone | 972-296-4777
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Fax | 972-296-5499
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Authorized Official
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Title or Position | MD
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Name | DR. RAJ KAKARLA
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Credential | MD
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Telephone | 972-296-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G0736
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License Number State | TX
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