Prasad R Koduru, PHD

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

Practice address

6000 Harry Hines Blvd
Dallas, TX 75235-5303

Phone

(214) 645-7000

Fax

(214) 645-7001

NPI assigned

Aug 4, 2011

Last updated

Aug 4, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1508145830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355303",
            "telephone_number": "214-645-7000",
            "fax_number": "214-645-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355303",
            "telephone_number": "214-645-7000",
            "fax_number": "214-645-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODURU",
        "first_name": "PRASAD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "PKODU1",
            "primary": false
        },
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "NY",
            "license": "PKODU1",
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "NY",
            "license": "PKODU1",
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lynn Koch, RN, ACNP
• Kate Kochu, CRNA
• Venkata Gopala Rao Kodali
• Anusha Kodidhi, MD
• Padmavathi Koduri, M.D.
• Mayra Cruz Koedam, FNP-C
• Alexandra Rose Koehler, MD
• Briana Koehler
• Bruce Eric Koehler II, MD
• Christine Koehler, LPC-S

• Clinical Laboratory Director (Non-physician) in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Laboratory Director (Non-physician) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.