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General NPI Number Information
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NPI Number | 1548406424
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Entity Type | Organization
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Legal Business Name | KOTESWARAMMA NARRA, MD, PA
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Dates
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Enumeration Date | 12/26/2008
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Last Update Date | 12/26/2008
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Provider Practice Location Address
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Address Line | 3819 22ND PL
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City | LUBBOCK
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State | TX
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Zip | 79410-1117
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Country | US
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Telephone | 806-300-0289
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Fax |
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Provider Business Mailing Address
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Address Line | 3819 22ND PL
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City | LUBBOCK
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State | TX
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Zip | 79410-1117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SONJA VADEN
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Credential |
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Telephone | 806-300-0289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | K0145
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License Number State | TX
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