Individual
DR. ASA DEEP KOGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 8TH AVE STE 135, FORT WORTH, TX 76104-4156
(817) 921-2153
(214) 579-6993
Mailing address
1505 LBJ FWY STE 700, DALLAS, TX 75234-6065
(214) 366-6012
(214) 579-6941
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
Q5458
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q5458
TX MEDICAL LICENSE
TX
Enumeration date
09/08/2010
Last updated
12/14/2023
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