Individual
DR. KALYANA CHAKRAVARTHI PONANGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
651 E CROCKETT ST, LULING, TX 78648-2602
(830) 875-6603
Mailing address
11708 JOHNNY WEISMULLER LN, AUSTIN, TX 78748-2975
(929) 393-5626
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39423
TX
Other
Enumeration date
06/19/2019
Last updated
05/10/2024
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