Individual
MADHAVA RAO KANAKAMEDALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
1000 S COULTER ST STE 100, AMARILLO, TX 79106-1781
(806) 358-8654
(806) 356-8687
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
208512947
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04978239
—
MS
05
—
404425701
—
TX
01
—
P01580613
RAILROAD MEDICARE
MS
Enumeration date
03/20/2009
Last updated
01/08/2020
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