Govindaraju, Kanakadurga

Govindaraju, Kanakadurga is an individual health care provider with primary practice located at 4107 Spicewood Springs Rd Ste 100 , Austin TX 78759-8645. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Govindaraju, Kanakadurga can be contacted via phone (512) 397-3360.

Contact Information

Primary practice address
4107 Spicewood Springs Rd Ste 100 Austin TX 78759-8645
Phone: (512) 397-3360
Fax: (512) 343-7107
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301065815 Michigan
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X L3318 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X L3318 Texas

Profile Details

NPI number 1003998840
LBN Legal business name Govindaraju, Kanakadurga
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2006
Last updated Jan 19th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003998840 NPPES
Texas MEDICAID 193186707
Texas MEDICAID 193186712
Texas MEDICAID 193186706
Texas Other 106362
Texas MEDICAID 193618708

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