Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | M7139 | TX |
NPI | 1407059561 |
---|---|
Provider Name | Dr. Geetha Malini Devdas |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 27/04/2021 |