Provider Demographics
NPI:1679769749
Name:KARUNA VANGALA MD PA
Entity type:Organization
Organization Name:KARUNA VANGALA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARUNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VANGALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-291-7181
Mailing Address - Street 1:316 W BELT LINE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2075
Mailing Address - Country:US
Mailing Address - Phone:972-291-7181
Mailing Address - Fax:
Practice Address - Street 1:316 W BELT LINE RD STE 100
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2075
Practice Address - Country:US
Practice Address - Phone:972-291-7181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00191XMedicare PIN