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General NPI Number Information
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NPI Number | 1659609766
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Entity Type | Individual
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Provider Name | PREMAKUMARI MURALI DURAISAMI M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 400 E QUINCY ST
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1934
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Country | US
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Telephone | 210-472-0211
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Fax | 210-472-0214
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Provider Business Mailing Address
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Address Line | 6049 LEESBURG PIKE 104
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City | FALLS CHURCH
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State | VA
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Zip | 22041-2221
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Country | US
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Telephone | 703-933-3073
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Fax | 703-933-3043
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101243225
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | T7311
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License Number State | TX
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