Provider Demographics
NPI:1558355883
Name:KODALI, UDAYINI (MD)
Entity Type:Individual
Prefix:
First Name:UDAYINI
Middle Name:
Last Name:KODALI
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:PO BOX 131898
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77393-1898
Mailing Address - Country:US
Mailing Address - Phone:832-813-5755
Mailing Address - Fax:832-813-8096
Practice Address - Street 1:920 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 290
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3260
Practice Address - Country:US
Practice Address - Phone:832-813-5755
Practice Address - Fax:832-813-8096
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM0463207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology