Provider Demographics
NPI:1154877405
Name:PALA, VARUN KUMAR (MD)
Entity type:Individual
Prefix:
First Name:VARUN KUMAR
Middle Name:
Last Name:PALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 GOLDEN OAK LN
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3183
Mailing Address - Country:US
Mailing Address - Phone:646-258-7627
Mailing Address - Fax:
Practice Address - Street 1:5015 GOLDEN OAK LN
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-3183
Practice Address - Country:US
Practice Address - Phone:646-258-7627
Practice Address - Fax:985-400-5303
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT211980207R00000X
LA3271522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine