Individual
DR. PRIYA R VENUGOPAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2817 S MAYHILL RD STE 270, DENTON, TX 76208-5970
(817) 749-2001
(817) 749-3316
Mailing address
PO BOX 92038, SOUTHLAKE, TX 76092-0101
(817) 749-2001
(940) 483-1568
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L5600
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020ML
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/20/2006
Last updated
03/07/2018
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