Individual
MUKUND I GUNDANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1602 ROCK PRAIRIE RD, SUITE 2400, COLLEGE STATION, TX 77845-8306
(979) 693-1815
(979) 693-4706
Mailing address
3526 LONGMIRE DR, STE 101, COLLEGE STATION, TX 77845-6473
(979) 693-1815
(979) 693-4706
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
L8709
TX
207XS0117X
Orthopaedic Surgery of the Spine Physician
L8709
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166886501
—
TX
Enumeration date
03/07/2006
Last updated
07/25/2018
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