Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | A76734 | CA |
Y | 213ES0000X | Sports Medicine | A76734 | CA |
NPI | 1295745685 |
---|---|
Provider Name | Dr. Geeta Kandala |
First Address | Dallas, TX 75216-7167 |
Second Address | Dallas, TX 75216-7167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |