Individual
DR. YAMINI K MADDALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
981 STATE HIGHWAY 121, SUITE 1140, ALLEN, TX 75013
(469) 697-5100
(469) 697-5105
Mailing address
7610 N STEMMONS FWY STE 600, DALLAS, TX 75247-4228
(214) 689-5960
(469) 713-8084
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M4314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185054701
—
TX
01
—
8B4314
BCBSTX
TX
Enumeration date
06/13/2006
Last updated
09/03/2020
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