Provider Demographics
NPI:1821253915
Name:POKURI, SARADA DEVI (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARADA
Middle Name:DEVI
Last Name:POKURI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SARADA
Other - Middle Name:DEVI
Other - Last Name:KOMMALAPATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:151 REGAL DR APT 26
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-2961
Mailing Address - Country:US
Mailing Address - Phone:210-507-5123
Mailing Address - Fax:
Practice Address - Street 1:116 W BURLESON RD
Practice Address - Street 2:
Practice Address - City:MART
Practice Address - State:TX
Practice Address - Zip Code:76664-1107
Practice Address - Country:US
Practice Address - Phone:254-722-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32978103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical