| R. Kattegummula, M.d, P.a. | |
|
215 Oak Dr S Ste K Lake Jackson TX 77566-5618 | |
| (979) 297-1652 | |
| (979) 297-6322 |
| Full Name | R. Kattegummula, M.d, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 215 Oak Dr S Ste K, Lake Jackson, Texas |
| Authorized Official Name and Position | Ranga Reddy Kattegummula (PRESIDENT) |
| Authorized Official Contact | 9792971652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R. Kattegummula, M.d, P.a. 215 Oak Dr S Ste K Lake Jackson TX 77566-5618 Ph: (979) 297-1652 | R. Kattegummula, M.d, P.a. 215 Oak Dr S Ste K Lake Jackson TX 77566-5618 Ph: (979) 297-1652 |
| NPI Number | 1417254756 |
|---|---|
| Provider Enumeration Date | 02/23/2011 |
| Last Update Date | 06/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417254756 | NPI | - | NPPES |
| P000R41V2 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G6317 (Texas) | Primary |
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