Provider Demographics
NPI:1356193858
Name:BODAPATI, ADI PRASAD
Entity type:Individual
Prefix:
First Name:ADI PRASAD
Middle Name:
Last Name:BODAPATI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11-7-1/2, POWER HOUSE STREET, RAMARAOPETA
Mailing Address - Street 2:
Mailing Address - City:KAKINADA
Mailing Address - State:ANDHRA PRADESH
Mailing Address - Zip Code:533004
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTRE - PERMIAN
Practice Address - Street 2:701 W 5TH STREET
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79763
Practice Address - Country:US
Practice Address - Phone:432-703-5089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program