Individual
PRASAD VENKATA KANNAEGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6331 BOULEVARD 26, SUITE 220, NORTH RICHLAND HILLS, TX 76180-1590
(817) 628-0284
(817) 628-0288
Mailing address
1600 WATERS RIDGE DR STE A, LEWISVILLE, TX 75057-6039
(972) 219-0558
(214) 466-7237
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
N1701
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
289661501
—
TX
Enumeration date
06/21/2005
Last updated
12/19/2023
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