Provider Demographics
NPI:1245265891
Name:MOLAKALAPALLI, SUDHAMAYI (MD)
Entity type:Individual
Prefix:
First Name:SUDHAMAYI
Middle Name:
Last Name:MOLAKALAPALLI
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 1:9330 AMBERTON PKWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2197
Mailing Address - Country:US
Mailing Address - Phone:214-570-3188
Mailing Address - Fax:214-570-3165
Practice Address - Street 1:9330 AMBERTON PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2197
Practice Address - Country:US
Practice Address - Phone:214-570-3188
Practice Address - Fax:214-570-3165
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177785602Medicaid
TX177785604Medicaid
TX177785605Medicaid
TX177785601Medicaid
TX8G0636Medicare ID - Type Unspecified
TX8J1385Medicare ID - Type Unspecified
TX177785604Medicaid
TXTXB121617Medicare PIN
TXTXB121629Medicare PIN