Doctor Name: | DR. LAXMAN R KALVAKUNTLA |
NPI Number: | 1013913623 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | J2627 |
Business Practice Address: | 63 Waterford Dr Nacogdoches, TX - 759658717 |
Business Phone Number: | 9366451044 |
Business Fax Number: | 9362051328 |
Mailing Address: | 63 Waterford Dr, NACOGDOCHES |
State: | TX |
Postal Code: | 759658717 |
Phone Number: | 9366451044 |
Fax Number: | 9362051328 |
NPI Enumeration Date: | 06/28/2005 |
NPI Last Update Date: | 09/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | J2627 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |