Organization
PRASAD MADDUKURI MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASAD V MADDUKURI MD (GOVERNING MEMBER)
(617) 319-1958
Entity
Organization
Contact information
Practice address
341 WHEATFIELD DR, SUITE 190, SUNNYVALE, TX 75182-4638
(972) 686-8200
Mailing address
PO BOX 850214, MESQUITE, TX 75185-0214
(888) 212-4243
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
P2895
TX
Other
Enumeration date
07/11/2016
Last updated
02/28/2020
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