Organization
MALLEPALLI MD A PROFESSIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKAT N. MALLEPALLI (PRESIDENT)
(318) 388-8561
Entity
Organization
Contact information
Practice address
2408 DUVAL DR STE 2, MONROE, LA 71201-2986
(318) 388-8561
(318) 388-8564
Mailing address
2408 DUVAL DR STE 2, MONROE, LA 71201-2986
(318) 388-8561
(318) 388-8564
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
12443R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1536199
—
LA
Enumeration date
03/19/2007
Last updated
06/26/2019
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