Individual
SRIDEVI KONKIMALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3765 S ALAMEDA ST STE 304, CORPUS CHRISTI, TX 78411-1671
(361) 884-2904
(361) 884-2919
Mailing address
PO BOX 61160, CORPUS CHRISTI, TX 78466-1160
(361) 884-2904
(361) 857-0572
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT187482
PA
207RN0300X
Nephrology Physician
7846
SD
207RN0300X
Nephrology Physician
Primary
R3894
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006350
—
SD
01
—
R3894
TEXAS MEDICAL BOARD
TX
Enumeration date
12/29/2006
Last updated
05/04/2021
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