Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A126180 | CA |
Y | 2080P0202X | Pediatric Cardiologist | 304683 | LA |
N | 2080P0202X | Pediatric Cardiologist | BP20048090 | TX |
NPI | 1174835631 |
---|---|
Provider Name | Dr. Durga P Naidu |
First Address | Lafayette, LA 70508-6951 |
Second Address | Lafayette, LA 70508-6951 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2010 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2452622 | (05) | LA |
BP20048090 | (05) | TX |