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General NPI Number Information
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NPI Number | 1649230087
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Entity Type | Individual
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Provider Name | PALLAVI KAKULAVAR M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 721 W. MULBERRY ST.
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City | ANGLETON
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State | TX
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Zip | 77515-9145
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Country | US
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Telephone | 281-536-7698
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Fax | 815-642-8581
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Provider Business Mailing Address
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Address Line | PO BOX 841149
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City | PEARLAND
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State | TX
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Zip | 77584-9145
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | M1810
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License Number State | TX
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