Basic Information
| Provider Information | |||||||||
| NPI: | 1457510869 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NALLAPANENI | ||||||||
| FirstName: | NAGALAKSHMI | ||||||||
| MiddleName: | KODURI | ||||||||
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| OtherLastName: | KODURI | ||||||||
| OtherFirstName: | NAGALAKSHMI | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2961 MOSSROCK | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782305119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107314800 | ||||||||
| FaxNumber: | 2107314810 | ||||||||
| Practice Location | |||||||||
| Address1: | 8542 WURZBACH RD | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106167300 | ||||||||
| FaxNumber: | 2106167359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2008 | ||||||||
| LastUpdateDate: | 01/18/2019 | ||||||||
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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 | 208M00000X | N4609 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | N4609 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.