DR. PRASAD R KODURU (NPI# 1508145830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508145830 |
| Entity Type | Individual |
| Full Name | DR. PRASAD R KODURU |
| Credential | PHD |
| Practice Address |
6000 Harry Hines Blvd Dallas TX 75235-5303 |
| Practice Telephone | 2146457000 |
| Practice Fax Number | 2146457001 |
| Mailing Telephone | 2146457000 |
| Mailing Fax Number | 2146457001 |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | PKODU1 | NY | Other Service Providers |
| N | 207SC0300X |
Medical Genetics Specialization: Clinical Cytogenetic |
PKODU1 | NY | Allopathic & Osteopathic Physicians |
| N | 207ZP0007X |
Pathology Specialization: Molecular Genetic Pathology |
PKODU1 | NY | Allopathic & Osteopathic Physicians |
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
6000 HARRY HINES BLVD |
| City | DALLAS |
| State | TX |
| Zip Code | 75235-5303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184711582 | Kathleen S Wilson | Pathology | 6000 Harry Hines Blvd, Hamon Bldg, Room Na2 508a, Dallas, TX 75390-0001 | 2006-10-06 |
| 1407211667 | Julianna Hudnall | Clinic/Center | 6000 Harry Hines Blvd, Nb 10.204, Dallas, TX 75235-5303 | 2015-12-15 |
| 1063665941 | Genetic Diagnostic Group | Medical Genetics | 6000 Harry Hines Blvd, Hamon Bldg, Room Na2 508a, Dallas, TX 75390-0001 | 2008-10-23 |
| 1962655811 | Genetic Diagnostics | Clinical Medical Laboratory | 6000 Harry Hines Blvd, Hamon Bldg, Room Na2 508a, Dallas, TX 75390-0001 | 2008-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265058895 | Kailey Elaine Flowers | Physical Therapy Assistant | 2400 Empire Central Drive, Suite B, Dallas, TX 75235 | 2020-06-19 |
| 1265061071 | Bella Xinyi O'malley | Student in an Organized Health Care Education/Training Program | 1935 Medical Drive, Dallas, TX 75235 | 2020-04-03 |
| 1427687318 | Can Ozlu | Student in an Organized Health Care Education/Training Program | Children's Medical Center of Dallas, 1935 Medical Distr, Dallas, TX 75235 | 2020-04-03 |
| 1689137515 | Tarek Mansi | Student in an Organized Health Care Education/Training Program | 2222 Medical District Dr Apt 4325, Dallas, TX 75235 | 2019-04-08 |
| 1386117125 | Christine Elizabeth Smith | Physician Assistant | 8134 Tex Oak Avenue, Dallas, TX 75235 | 2019-01-04 |
| 1447720016 | Michelle Angelina Dye | Physician Assistant | 5959 Maple Avenue Apt 1171, Dallas, TX 75235 | 2018-11-27 |
| 1255869335 | Andrea Nicole Pennington-peace | Specialist/Technologist, Other | 1935 Medial District, Dallas, TX 75235 | 2017-06-01 |
| 1194258152 | Tricia Rood | Student in an Organized Health Care Education/Training Program | 5200 Harry Hines Blvd., Dallas, TX 75235 | 2017-04-06 |
| 1437690971 | Robin Lee | Counselor | 8915 Hrry Hines Blvd, Dallas, TX 75235 | 2017-03-16 |
| 1871033746 | Javier Davila-lopez | Counselor | 1545 Mockingbird Lane, Suite 4000, Dallas, TX 75235 | 2017-02-27 |
| Find all providers in zip 75235 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336694496 | Pheleicia Biggins | Pathology | 4116 Summitt Ridge Dr, Dallas, TX 75216-6016 | 2016-08-18 |
| 1356623821 | Alagarraju Muthukumar | Pathology | 5323 Harry Hines Blvd., Department of Pathology, Ste Cs 3.114, Dallas, TX 75390-9073 | 2011-09-12 |
| 1902191422 | Chantale Lacelle | Pathology | 5323 Harry Hines Blvd Rm G4.212, Dallas, TX 75390-8886 | 2011-06-13 |
| 1013142660 | Rita Gander | Pathology | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2009-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033719059 | Kenesha Barnes | Pathology | 9120 Monica St, Beaumont, TX 77707-4634 | 2020-10-28 |
| 1417574922 | Thomas King Huard | Pathology | 112 Bellagio Dr, Austin, TX 78734-5081 | 2020-06-30 |
| 1932740313 | Stephanie Halliday | Pathology | 2023 Gentryside Dr Unit 102, Houston, TX 77077-3657 | 2019-10-07 |
| 1699232504 | Xia Wang | Pathology | 1920 Country Place Pkwy # 100, Pearland, TX 77584-2282 | 2019-02-27 |
| 1982178000 | Quantacia Miner | Pathology | 613 Bridgewood Cir Apt 524, Fort Worth, TX 76112-1729 | 2019-01-11 |
| 1710479530 | Herbert A Fritsche Jr. | Pathology | 12117 Bee Caves Road, Building 3 Suite 100, Austin, TX 78738 | 2018-06-06 |
| 1447671292 | Alvin Spiekerman | Pathology | 16300 Addison Rd, Addison, TX 75001-5346 | 2013-12-20 |
| 1659704724 | Christopher Byers | Pathology | 6682 Escondido St, Irving, TX 75039-4208 | 2013-08-13 |
| 1740567841 | Stephen Ray Harlow | Pathology | 201 Laurence, #108, Heath, TX 75032 | 2011-11-03 |
| 1700495348 | Kingspoint Stat Laboratory | Pathology | 18839 Mckay Dr, Humble, TX 77338-5721 | 2020-07-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.