Individual
ASHRITHA PENAGALURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0177
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
328069
LA
207RC0000X
Cardiovascular Disease Physician
328069
LA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
328069
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
MEDICARE
MD
05
—
NA
—
MD
Enumeration date
07/04/2012
Last updated
07/19/2023
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