Individual
LAKSHMI TATINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(373) 480-8066
(337) 480-8109
Mailing address
PO BOX 122108 DEPT 2108, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
343462
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2021
Last updated
09/17/2024
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