Provider Demographics
NPI:1649372749
Name:POTTI, ARUNA KONEY (MD)
Entity type:Individual
Prefix:
First Name:ARUNA
Middle Name:KONEY
Last Name:POTTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARUNA
Other - Middle Name:
Other - Last Name:KONEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1151 N BUCKNER BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3426
Mailing Address - Country:US
Mailing Address - Phone:972-761-9750
Mailing Address - Fax:
Practice Address - Street 1:1151 N BUCKNER BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218
Practice Address - Country:US
Practice Address - Phone:214-320-1200
Practice Address - Fax:214-320-9400
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3778207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00235QOtherBCBS
G53736Medicare UPIN
00525VMedicare PIN