Individual
LEENA R. KODALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8264 HIGHWAY 6 LOOP, NAVASOTA, TX 77868-3292
(979) 207-6100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
D67788
MD
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
Q9178
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415877600
—
MD
Enumeration date
07/16/2007
Last updated
02/20/2020
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