# SODHA MEDICAL PA

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

## Provider details

- **NPI number:** 1770860751
- **Authorized official:** PRABHAV K TELLA M.D. (PRESIDENT)
- **Authorized official phone:** (972) 956-5541

## Contact information

- **Practice address:** 108 SAN GABRIEL DR, IRVING, TX 75039-3350
- **Practice address phone:** (972) 956-5541
- **Mailing address:** 405 STATE HIGHWAY 121 BYP, BUILDING A SUITE 150, LEWISVILLE, TX 75067-8214
- **Mailing address phone:** (972) 956-5541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | M2854 | TX | Yes |

## Other

- **Enumeration date:** 11/04/2011
- **Last updated:** 11/04/2011