Organization
PALLAVI KAKULAVAR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PALLAVI KAKULAVAR M.D (PHYSICIAN)
(281) 536-7698
Entity
Organization
Contact information
Practice address
721 W MULBERRY ST, ANGLETON, TX 77515-9145
(281) 536-7698
(815) 642-8581
Mailing address
PO BOX 841149, PEARLAND, TX 77584-9145
(281) 536-7698
(815) 642-8581
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
M1810
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088SU
BCBS
TX
05
—
216617501
—
TX
01
—
DQ1990
PALMETTO GPA RAILROAD MEDICARE
TX
Enumeration date
05/18/2009
Last updated
09/28/2018
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