Basic Information
| Provider Information | |||||||||
| NPI: | 1437240892 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAZA | ||||||||
| FirstName: | LEELAMANI | ||||||||
| MiddleName: | NAGAPUSHPA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KAZA | ||||||||
| OtherFirstName: | NAGAPUSHPA | ||||||||
| OtherMiddleName: | LEELAMANI | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | P O BOX 70 | ||||||||
| Address2: | |||||||||
| City: | TERRELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751609000 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 E. BRIN | ||||||||
| Address2: | |||||||||
| City: | TERRELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725246452 | ||||||||
| FaxNumber: | 9725518513 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 08/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | K6622 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.