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NPI Code Detail

MEDICARE: KOMALI KANAGALA

MEDICARE: KOMALI KANAGALA
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
1207R00000XInternal Medicine PhysicianS7076TX
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1083169460
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOMALI KANAGALA
Provider Business Mailing Address
First Line : 2423 FOUNTAIN DR
Second Line :
City : IRVING
State : TX
Zip : 75063-3536
Country : US
Telephone Number : 469-524-9996
Fax Number :
Provider Business Practice Location Address
First Line : 6800 N MACARTHUR BLVD
Second Line :
City : IRVING
State : TX
Zip : 75039-2422
Country : US
Telephone Number : 972-969-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2016
Last Update Date : 03/06/2026

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Directions to “ KOMALI KANAGALA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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