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General NPI Number Information
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NPI Number | 1427443886
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Entity Type | Organization
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Legal Business Name | SYLAZA KANTAMNENI MEDICAL PC
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 2908 GREENFIELD CT
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City | RICHARDSON
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State | TX
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Zip | 75082-3896
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Country | US
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Telephone | 972-707-0521
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Fax |
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Provider Business Mailing Address
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Address Line | 2908 GREENFIELD CT
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City | RICHARDSON
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State | TX
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Zip | 75082-3896
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Country | US
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Telephone | 972-707-0521
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYLAZA KANTAMNENI
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Credential | MD
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Telephone | 972-707-0521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | P9209
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License Number State | TX
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