# MALLEPALLI MD A PROFESSIONAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447374921
- **Authorized official:** DR. VENKAT N. MALLEPALLI (PRESIDENT)
- **Authorized official phone:** (318) 388-8561

## Contact information

- **Practice address:** 2408 DUVAL DR STE 2, MONROE, LA 71201-2986
- **Practice address phone:** (318) 388-8561
- **Practice address fax:** (318) 388-8564
- **Mailing address:** 2408 DUVAL DR STE 2, MONROE, LA 71201-2986
- **Mailing address phone:** (318) 388-8561
- **Mailing address fax:** (318) 388-8564

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 12443R | LA | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 06/26/2019