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General NPI Number Information
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NPI Number | 1407322449
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Entity Type | Organization
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Legal Business Name | CHANDANA KONDURU, PLLC
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 04/10/2020
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Provider Practice Location Address
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Address Line | 3602 MATLOCK RD STE 202
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City | ARLINGTON
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State | TX
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Zip | 76015-3600
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Country | US
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Telephone | 682-302-0430
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Fax |
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Provider Business Mailing Address
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Address Line | 14850 MONTFORT DRIVE SUITE 181, LB 11
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City | DALLAS
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State | TX
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Zip | 75254
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Country | US
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Telephone | 214-550-1469
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Fax | 214-446-6010
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Authorized Official
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Title or Position | CONSULTANT
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Name | ADRIANE ALEXANDER
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Credential |
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Telephone | 214-550-1469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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