Organization Active NPI

Gonnalagadda PLLC

  • Family Medicine Physician
  • Frisco, TX
National Provider Identifier
1851774079
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q2446 Issued in TX
Legal business name
GONNALAGADDA PLLC
Practice address
5140 Legendary Dr Ste 100
Frisco, TX 75034-9042
Phone
(469) 850-1432
NPI assigned
Jul 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

Name
Sreeram Gonnalagadda, M.D.NPI 1568520187
Title
Owner/Manager
Phone
(469) 850-1432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Q2446 TX Primary

Addresses

Primary practice location

5140 Legendary Dr Ste 100
Frisco, TX 75034-9042

Mailing address

5140 Legendary Dr Ste 100
Frisco, TX 75034-9042
Phone (469) 850-1432

Other identifiers 1

IdentifierTypeStateIssuer
3566481MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811004646 TX Part B Supplier - Clinic/Group Practice 0941515522 Receives reassigned benefits from 1 practitioner
Practice locations: Frisco, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2250297Gonnalagadda, PLLC5140 Legendary Drive Suite 100, Frisco, TX 75034Certificate of waiverJan 25, 2028

National Provider Directory

National Provider Directory

Locations

5140 Legendary Dr
Ste 100A
Frisco, TX 75034
Phone (972) 867-9507

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1851774079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 LEGENDARY DR STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349042",
            "telephone_number": "469-850-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 LEGENDARY DR STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349042",
            "telephone_number": "469-850-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONNALAGADDA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "GONNALAGADDA",
        "authorized_official_first_name": "SREERAM",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "469-850-1432",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q2446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3566481",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.