Organization · NPI-2

R. Kattegummula, M.D, P.A.

Internal Medicine · Lake Jackson, TX

NPI number1417254756
StatusActive
Last updated in NPPESJun 14, 2012

Details

NPI
1417254756
Entity type
Organization (NPI-2)
Legal business name
R. Kattegummula, M.D, P.A.
Organization subpart
No
Enumeration date
Feb 23, 2011
Last updated
Jun 14, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineG6317TXYes

Practice location

215 Oak Dr S Ste K
Lake Jackson, TX 77566-5618

Phone 979-297-1652 · Fax 979-297-6322

Mailing address

215 Oak Dr S Ste K
Lake Jackson, TX 77566-5618

Phone 979-297-1652 · Fax 979-297-6322

Authorized official

Ranga Reddy Kattegummula
President
9792971652

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