Individual
PRASAD DURGA GADIRAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 S TYLER ST STE 2100, AMARILLO, TX 79101-2304
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
K3732
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042019201
—
TX
01
—
050064613
RAILROAD MEDICARE
TX
01
—
83375F
TX-BLUE SHIELD
—
Enumeration date
01/10/2007
Last updated
04/30/2020
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