Organization
SUMANKRISHNA KOTLA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUMANKRISHNA KOTLA M.D. (OWNER)
(814) 248-8894
Entity
Organization
Contact information
Practice address
411 N WASHINGTON AVE STE 6000, DALLAS, TX 75246-1789
(214) 358-2300
(214) 579-6988
Mailing address
1505 LBJ FWY STE 700, DALLAS, TX 75234-6065
(214) 358-2300
(214) 579-6941
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1400
MEDICAL LICENSE
TX
Enumeration date
11/28/2016
Last updated
12/15/2023
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