Individual
VAISHNAVI THEEGALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(501) 526-5310
Mailing address
603 SUFFOLK RD, JOHNSON CITY, TN 37615-3993
(740) 272-8364
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
—
TN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/08/2021
Last updated
03/22/2024
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