Organization
MAA COTULLA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKATA RAJESH KUMAR PASUPULETI (OWNER)
(661) 618-4215
Entity
Organization
Contact information
Practice address
649 LAS PALMAS BLVD STE 8, COTULLA, TX 78014-3209
(661) 618-4215
Mailing address
649 LAS PALMAS BLVD STE 8, COTULLA, TX 78014-3209
(661) 618-4215
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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