Individual
VENKATAKRISHNA KAKKILAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
DEPARTMENT OF PEDIATRICS, 5323 HARRY HINES BLVD, DALLAS, TX 75390-9063
(214) 648-3903
(214) 648-2481
Mailing address
DEPARTMENT OF PEDIATRICS, 5323 HARRY HINES BLVD, DALLAS, TX 75390-9063
(214) 648-3903
(214) 648-2481
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
N9078
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280151602
—
TX
Enumeration date
05/24/2007
Last updated
10/07/2011
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