Bodavula Pediatrics Pllc

LBN: Bodavula Pediatrics Pllc
Bodavula Pediatrics Pllc is an health care organization with primary practice located at 6448 Broadway Blvd , Garland TX 75043-7504. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Bodavula Pediatrics Pllc can be contacted via phone (972) 216-8500, or through Bodavula, Phani via phone (314) 620-5823.

Contact Information

Primary practice address
6448 Broadway Blvd Garland TX 75043-7504
Fax: (972) 216-8521
Website:
Authorized official contact:
Name: Bodavula, Phani Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1366008294
LBN Legal business name Bodavula Pediatrics Pllc
DBA Doing business as
Authorized official Bodavula, Phani Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 16th, 2019
Last updated Aug 5th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366008294 NPPES
Texas MEDICAID 32070567899
Texas Other 32070567899

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