Provider Demographics
NPI:1639542731
Name:PADAYATTI, JOPHY L (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JOPHY
Middle Name:L
Last Name:PADAYATTI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:JOPHY
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1662 BRIGHTON DOWNS
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-4885
Mailing Address - Country:US
Mailing Address - Phone:973-325-6752
Mailing Address - Fax:972-253-4218
Practice Address - Street 1:385 E BELT LINE RD
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2206
Practice Address - Country:US
Practice Address - Phone:972-299-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily