Provider Demographics
NPI:1619278876
Name:PADMINI BHADRIRAJU MD P.A.
Entity Type:Organization
Organization Name:PADMINI BHADRIRAJU MD P.A.
Other - Org Name:CATALYST MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PADMINI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHADRIRAJU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-7100
Mailing Address - Street 1:2000 S MCCOLL RD STE B #303
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:956-815-1027
Mailing Address - Fax:956-720-0839
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
Practice Address - Country:US
Practice Address - Phone:956-631-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208M00000X
TXN3498261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1619278876Medicaid
TX1619278876Medicaid