Individual
DR. PRAVEEN KUMAR THANGADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
634 E COURT ST, STE 102, SEGUIN, TX 78155-5725
(830) 303-1819
(830) 379-0816
Mailing address
115 GALLERY CIR, STE 300, SAN ANTONIO, TX 78258-3389
(830) 303-1819
(830) 379-0816
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J7226
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099550802
—
TX
Enumeration date
03/23/2006
Last updated
11/03/2016
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