MEDICARE: DR. KONDAPAVULURU LAKSHMI 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	207R00000X	Internal Medicine Physician	G6329	TX

General Provider Information

NPI Number	:	1750323002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KONDAPAVULURU LAKSHMI M.D.

Provider Business Mailing Address
First Line	:	7410 W EXPWY 83
Second Line	:
City	:	PALMVIEW
State	:	TX
Zip	:	78572-9527
Country	:	US
Telephone Number	:	956-585-2010
Fax Number	:	956-584-8460

Provider Business Practice Location Address
First Line	:	7410 W EXPWY 83
Second Line	:
City	:	PALMVIEW
State	:	TX
Zip	:	78572-9527
Country	:	US
Telephone Number	:	956-585-2010
Fax Number	:	956-584-8460

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/09/2007

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