Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | Q1393 | TX |
NPI | 1013156462 |
---|---|
Provider Name | Dr. Srikala Meka Devabhaktuni |
First Address | Dallas, TX 75284-4658 |
Second Address | Marble Falls, TX 78654-8606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2009 |
Last Update Date | 11/01/2021 |