Provider Demographics
NPI:1518991447
Name:BHADRIRAJU, PADMINI (MD)
Entity Type:Individual
Prefix:
First Name:PADMINI
Middle Name:
Last Name:BHADRIRAJU
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 1:2000 S MCCOLL RD STE B
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1516
Mailing Address - Country:US
Mailing Address - Phone:956-631-7100
Mailing Address - Fax:956-631-5901
Practice Address - Street 1:5215 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-7861
Practice Address - Country:US
Practice Address - Phone:956-631-7100
Practice Address - Fax:956-631-5901
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3498208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2144925-04Medicaid
TXTXB126422OtherWELLMED
MI4699935Medicaid
TXTXB126391OtherPMG, PA
TXTXB126422OtherWELLMED
OD36000033Medicare ID - Type Unspecified