Individual
DR. KAMESWARI SURYA KONDURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1115 KINWEST PKWY, SUITE 100, IRVING, TX 75063-3409
(972) 401-0545
(972) 401-0614
Mailing address
2300 SOUTHERN OAK DR, IRVING, TX 75063-3489
(972) 444-9626
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
M2678
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199239801
—
TX
01
—
8BQ921
BCBS
TX
Enumeration date
03/23/2007
Last updated
06/30/2009
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