Individual
DR. KOMARANAHALLI P. GANESHAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 CAMDEN STREET, SAN ANTONIO, TX 78215-1639
(210) 253-3422
(210) 227-9833
Mailing address
PO BOX 17650, SAN ANTONIO, TX 78217-0650
(210) 253-3422
(210) 227-9833
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G4578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097437002
—
TX
01
—
100007418
MEDICARE - RAILROAD
TX
01
—
88X770
BC/BS
TX
Enumeration date
09/20/2006
Last updated
05/09/2013
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