Individual
UDAY S KANAMALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12700 PARK CENTRAL DR, SUITE 430, DALLAS, TX 75251-1500
(972) 239-8902
(972) 661-2551
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3194
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
P3177
TX
2085R0204X
Vascular & Interventional Radiology Physician
P3177
TX
Other
Enumeration date
10/13/2005
Last updated
12/18/2023
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