MEDICARE: DR. VINEEL KANKANALA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	R3881	TX

General Provider Information

NPI Number	:	1023307808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINEEL KANKANALA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 35629
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-0629
Country	:	US
Telephone Number	:	214-424-2200
Fax Number	:	214-231-2159

Provider Business Practice Location Address
First Line	:	12200 PARK CENTRAL DR STE 403
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-2126
Country	:	US
Telephone Number	:	972-780-7300
Fax Number	:	972-780-5817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2011
Last Update Date	:	01/27/2026

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