Provider Demographics
NPI:1447261839
Name:MOKKALA, SANDHYA-RANI (MD)
Entity type:Individual
Prefix:DR
First Name:SANDHYA-RANI
Middle Name:
Last Name:MOKKALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15522 CONIFER BAY CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3186
Mailing Address - Country:US
Mailing Address - Phone:832-423-5328
Mailing Address - Fax:
Practice Address - Street 1:2 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4127
Practice Address - Country:US
Practice Address - Phone:281-661-1031
Practice Address - Fax:281-661-1032
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0432207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F9819OtherMEDICARE PTAN
TX8F9819OtherMEDICARE PTAN