Individual provider Active NPI

Sangeetha Lakshmi Kolluri, DO

  • Surgical Oncology Physician
  • West Lake Hills, TX
National Provider Identifier
1790096543
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
Q5682 Issued in TX
Practice address
4613 Bee Caves Rd Ste 102
West Lake Hills, TX 78746-5206
Phone
(512) 862-1881
Fax
(512) 862-2433
NPI assigned
Jun 27, 2010
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Q5682 TX
Surgical Oncology Physician 2086X0206X Q5682 TX Primary

Addresses

Primary practice location

4613 Bee Caves Rd Ste 102
West Lake Hills, TX 78746-5206

Mailing address

4613 Bee Caves Rd Ste 102
West Lake Hills, TX 78746-5206
Phone (512) 862-1881

Other practice location 1

1180 Seton Pkwy
Ste 320
Kyle, TX 78640-6319
Phone (512) 862-1881

Other identifiers 1

IdentifierTypeStateIssuer
360601401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160725001496 TX Practitioner - Surgical Oncology 4688972532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wildflower Breast Center, PLLCGroup PAC ID 1153705108, 4 clinicians

Practice addresses (Care Compare)

4613 Bee Caves Rd
Suite 102
West Lake Hills, TX 78746-5206
Phone (512) 862-1881

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy30
Melanoma (skin cancer) excision18
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Wildflower Breast Center, PLLC Surgical Oncology CurrentSince Aug 1, 2022 Accepting new patients
Texas Oncology PA Surgery CurrentSince Sep 1, 2016 Accepting new patients
Central Texas Medical Specialists PLLC Surgery CurrentSince Mar 1, 2020 Accepting new patients
Central Texas Medical Specialists, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Texas Oncology PA Surgery CurrentSince Sep 1, 2016 Accepting new patients

Locations

2121 Lohmans Crossing Rd
Ste 504714
Austin, TX 78734

2600 E Mlk Blvd
Austin, TX 78702
Phone (512) 505-5571

2911 Medical Arts St
Ste 3
Austin, TX 78705
Phone (512) 391-0175

900 E 30th St
Ste 100
Austin, TX 78705
Phone (512) 334-2777

9715 Burnet Rd
Ste 200
Austin, TX 78758
Phone (512) 334-2866

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

1180 Seton Pkwy
Ste 320
Kyle, TX 78640
Phone (512) 651-0702

1300 Dacy Ln
Ste 250
Kyle, TX 78640
Phone (512) 862-1881

2130 NE Loop 410
Ste 100
San Antonio, TX 78217
Phone (210) 242-6541

4613 Bee Caves Rd
Ste 102
West Lake Hills, TX 78746
Phone (512) 448-0900

Interoperability endpoints

  • Direct secure messaging: sangeetha.kolluri.1@28614.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1790096543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 BEE CAVES RD STE 102",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465206",
            "telephone_number": "512-862-1881",
            "fax_number": "512-862-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 BEE CAVES RD STE 102",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465206",
            "telephone_number": "512-862-1881",
            "fax_number": "512-862-2433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1180 Seton Pkwy",
            "address_2": "Ste 320",
            "address_purpose": "LOCATION",
            "city": "Kyle",
            "state": "TX",
            "postal_code": "786406319",
            "country_code": "US",
            "telephone_number": "512-862-1881",
            "fax_number": "512-862-2433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLURI",
        "first_name": "SANGEETHA",
        "middle_name": "LAKSHMI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-27",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q5682",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "Q5682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360601401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

Verify at the official NPI Registry.