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General NPI Number Information
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NPI Number | 1700373388
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Entity Type | Individual
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Provider Name | NITIN KONDAPALLI MBBS
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Gender | Male
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 3500 GASTON AVE
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City | DALLAS
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State | TX
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Zip | 75246-2017
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Country | US
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Telephone | 214-820-2361
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Fax |
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Provider Business Mailing Address
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Address Line | 1351 MEADOW CREEK DR APT 364
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City | IRVING
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State | TX
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Zip | 75038-7250
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Country | US
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Telephone | 682-347-3384
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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