Individual
PRASAD V MADDUKURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
341 WHEATFIELD DR, SUITE 190, SUNNYVALE, TX 75182-4638
(214) 206-3695
(866) 313-9413
Mailing address
P.O BOX 850214, MESQUITE, TX 75185-0214
(214) 206-3695
(866) 313-9413
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
P2895
TX
207RI0011X
Interventional Cardiology Physician
P2895
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303013201
—
TX
01
—
TXB159166
MEDICARE
TX
Enumeration date
05/12/2006
Last updated
12/10/2019
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