Koganti, Madhuri Latha

Koganti, Madhuri Latha is an individual health care provider with primary practice located at 231 W Southlake Blvd Ste 100 , Southlake TX 76092-7037. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Koganti, Madhuri Latha can be contacted via phone (817) 865-6280.

Contact Information

Primary practice address
231 W Southlake Blvd Ste 100 Southlake TX 76092-7037
Phone: (817) 865-6280
Fax: (817) 865-6287
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X P0248 Texas

Profile Details

NPI number 1467557124
LBN Legal business name Koganti, Madhuri Latha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Jul 18th, 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 1467557124 NPPES
Texas MEDICAID 288388601

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