| Anuradha Kantamani, Md Pa | |
|
701 S Fry Rd Ste 105 Katy TX 77450-2243 | |
| (281) 398-5863 | |
| (281) 398-1430 |
| Full Name | Anuradha Kantamani, Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 701 S Fry Rd, Katy, Texas |
| Authorized Official Name and Position | Anuradha Kantamani (PRESIDENT) |
| Authorized Official Contact | 2813985863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anuradha Kantamani, Md Pa 701 S Fry Rd Ste 105 Katy TX 77450-2243 Ph: (281) 398-5863 | Anuradha Kantamani, Md Pa 701 S Fry Rd Ste 105 Katy TX 77450-2243 Ph: (281) 398-5863 |
| NPI Number | 1013270206 |
|---|---|
| Provider Enumeration Date | 06/21/2012 |
| Last Update Date | 09/02/2014 |
| Medicare PECOS PAC ID | 2264688969 |
|---|---|
| Medicare Enrollment ID | O20120813000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013270206 | NPI | - | NPPES |
| 3322901-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K4097 (Texas) | Primary |
| Provider Name | Anuradha Kantamani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649244054 PECOS PAC ID: 2769640838 Enrollment ID: I20120221000181 |
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