Individual
TEJASWI KATAKAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 330-7615
Mailing address
613 16TH ST, ARGYLE, TX 76226-3389
(571) 309-5636
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
V1508
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2021
Last updated
06/27/2024
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