Individual
DR. KANTHI YALAMANCHILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4370 MEDICAL ARTS DR STE 295, FLOWER MOUND, TX 75028-1742
(972) 691-3777
(972) 691-3666
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2200
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
L9562
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200340202
—
TX
01
—
8CW400
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/04/2007
Last updated
02/01/2024
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