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Individual

KISHORE PATCHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
301 UNIVERSITY BLVD, 4.174 JOHN SEALY ANNEX, GALVESTON, TX 77555-0566
(409) 772-7399
Mailing address
30 N 1900 E RM 4R312, SALT LAKE CITY, UT 84132-0002

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10043728
TX
207R00000X
Internal Medicine Physician
Q3571
TX
207RN0300X
Nephrology Physician
Primary
10310641-1205
UT

Other

Enumeration date
07/13/2012
Last updated
11/11/2021
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