# PRASAD MADDUKURI MD PLLC

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

## Provider details

- **NPI number:** 1922450170
- **Authorized official:** PRASAD V MADDUKURI MD (GOVERNING MEMBER)
- **Authorized official phone:** (617) 319-1958

## Contact information

- **Practice address:** 341 WHEATFIELD DR, SUITE 190, SUNNYVALE, TX 75182-4638
- **Practice address phone:** (972) 686-8200
- **Mailing address:** PO BOX 850214, MESQUITE, TX 75185-0214
- **Mailing address phone:** (888) 212-4243

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | P2895 | TX | Yes |

## Other

- **Enumeration date:** 07/11/2016
- **Last updated:** 02/28/2020