Provider Demographics
NPI:1982803458
Name:PADALA, ARUN K (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:K
Last Name:PADALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MISTLETOE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4050
Mailing Address - Country:US
Mailing Address - Phone:817-338-1300
Mailing Address - Fax:817-335-9871
Practice Address - Street 1:12500 DALLAS PKWY STE 4.600
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4231
Practice Address - Country:US
Practice Address - Phone:469-495-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8967207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX357112YT79OtherMEDICARE PTAN
TX207RI0011XOtherTAXONOMY
TX338428103Medicaid
TX357112ZHL4OtherMEDICARE PTAN
TX338428103Medicaid