Provider Demographics
NPI:1144332008
Name:VEGUNTA, RAJAKUMARI I (MD)
Entity type:Individual
Prefix:DR
First Name:RAJAKUMARI
Middle Name:
Last Name:VEGUNTA
Suffix:I
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 1:333 LINKS DR
Mailing Address - Street 2:APT 1910
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-8549
Mailing Address - Country:US
Mailing Address - Phone:870-773-2295
Mailing Address - Fax:
Practice Address - Street 1:910 REALTOR AVE
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-1020
Practice Address - Country:US
Practice Address - Phone:870-216-2242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021533E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist