# SREEDEVI KODALI, M.D., PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548597289
- **Authorized official:** SREEDEVI KODALI M.D. (PRESIDENT)
- **Authorized official phone:** (817) 868-1616

## Contact information

- **Practice address:** 5209 HERITAGE AVE, SUITE 220, COLLEYVILLE, TX 76034-5987
- **Practice address phone:** (817) 868-1616
- **Practice address fax:** (817) 868-1617
- **Mailing address:** 5209 HERITAGE AVE, SUITE 220, COLLEYVILLE, TX 76034-5987
- **Mailing address phone:** (817) 868-1616
- **Mailing address fax:** (817) 868-1617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | M6238 | TX | Yes |

## Other

- **Enumeration date:** 11/16/2009
- **Last updated:** 02/02/2010