Organization
LAKSHMI K DASARI PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKSHMI K DASAREE (LAKSHMI K DASAREE MD)
(901) 763-0730
Entity
Organization
Contact information
Practice address
6005 PARK AVE, STE 720B, MEMPHIS, TN 38119-5202
(901) 763-0730
(901) 763-0270
Mailing address
PO BOX 3034, CORDOVA, TN 38088-3034
(901) 763-0579
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD30076
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000118233
UNISON HEALTHPLAN
—
01
—
125215000
US DEPT OF LABOR
—
05
—
134469001
—
AR
01
—
228634705
TRICARE
—
05
—
3380512
—
TN
01
—
4053624
BCBST
—
01
—
5010784
TLC FAMILY HEALTHCARE
—
Enumeration date
06/19/2007
Last updated
01/18/2013
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