Provider Demographics
NPI:1003816745
Name:UPPALAPATI, PADMAVATHY (MD)
Entity Type:Individual
Prefix:DR
First Name:PADMAVATHY
Middle Name:
Last Name:UPPALAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 COTTONWOOD LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6117
Mailing Address - Country:US
Mailing Address - Phone:972-607-2525
Mailing Address - Fax:972-252-8837
Practice Address - Street 1:1110 COTTONWOOD LN
Practice Address - Street 2:SUITE 105
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6117
Practice Address - Country:US
Practice Address - Phone:972-607-2525
Practice Address - Fax:972-252-8837
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0670207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047595604Medicaid
TX047595603Medicaid
TX047595605Medicaid
TX047595603Medicaid
H23399Medicare UPIN
TXTXB113359Medicare PIN
TX047595605Medicaid
TXP00927109Medicare PIN