Individual
DR. SUBRAMANYA VARA PRASAD GAJARAJU VENKATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
310 GASLIGHT BLVD, LUFKIN, TX 75904-3133
(936) 632-8787
Mailing address
310 GASLIGHT BLVD, LUFKIN, TX 75904-3133
(366) 328-7879
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
R2337
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
R2337
TX
207RI0011X
Interventional Cardiology Physician
Primary
R2337
TX
Other
Enumeration date
07/16/2009
Last updated
03/22/2023
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