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Individual
PADMAVATHAMMA POTHALA
Active
Individual
PADMAVATHAMMA POTHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L0909
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082HO
BLUE CROSS BLUE SHIELD
—
01
—
110238080
RAILROAD MEDICARE
—
05
—
146623702
—
TX
Enumeration date
10/18/2006
Last updated
11/23/2009
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