Muddasani, Pavani

Muddasani, Pavani is an individual health care provider with primary practice located at 508 S Adams St Ste 202 , Fort Worth TX 76104-2151. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Muddasani, Pavani can be contacted via phone (817) 877-3446.

Contact Information

Primary practice address
508 S Adams St Ste 202 Fort Worth TX 76104-2151
Fax: (817) 377-6553
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X M3657 Texas

Profile Details

NPI number 1992781330
LBN Legal business name Muddasani, Pavani
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Nov 3rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992781330 NPPES
Texas MEDICAID 184525703

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