Individual
MADHURI LATHA KOGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
231 W SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-7037
(817) 865-6280
(817) 865-6287
Mailing address
231 W SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-7037
(817) 865-6280
(817) 865-6287
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
P0248
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288388601
—
TX
Enumeration date
09/14/2006
Last updated
07/18/2023
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