Individual
DR. PRAVEEN RANGA SRUNGARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8200 WALNUT HILL LN, DALLAS, TX 75231-4402
(214) 345-5634
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(214) 345-5634
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M4562
TX
207RG0100X
Gastroenterology Physician
Primary
M4562
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1878753-04
—
TX
01
—
P00958818
MEDICARE RAILROAD
TX
Enumeration date
09/27/2006
Last updated
04/19/2024
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