Individual
MRS. GAYATHRI TALLURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
931 NORTH CANAL BLVD, THIBODAUX, LA 70301
(985) 446-6381
(985) 446-5992
Mailing address
931 NORTH CANAL BLVD, THIBODAUX, LA 70301
(985) 446-6381
(985) 446-5992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13169R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1557412
—
LA
Enumeration date
07/16/2006
Last updated
02/23/2017
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