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Individual

SHARADA D PENUGONDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
5656 BEE CAVES RD, D204, WEST LAKE HILLS, TX 78746-5280
(512) 327-9251
(512) 327-9742
Mailing address
5656 BEE CAVES RD, D204, WEST LAKE HILLS, TX 78746-5280
(512) 327-9251
(512) 327-9742

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1626
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00AP45
GROUP PTAN
TX
05
183566201
TX
Enumeration date
09/20/2006
Last updated
09/19/2013
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