Organization
TEXAS KIDZ CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KESTURKOPPAL MURALIDHARA MD (PRESIDENT)
(956) 225-2401
Entity
Organization
Contact information
Practice address
800 E DOVE AVE, SUITE H1, MCALLEN, TX 78504-2262
(956) 225-2401
(888) 794-8753
Mailing address
800 E DOVE AVE, SUITE H1, MCALLEN, TX 78504-2262
(956) 225-2401
(888) 794-8753
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215664802
—
TX
05
—
296117901
—
TX
05
—
296117902
—
TX
Enumeration date
04/18/2012
Last updated
03/02/2016
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