Individual
PADMAVATHI N SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1845 PRECINCT LINE RD STE 209, HURST, TX 76054-3109
(817) 336-4638
(817) 336-1331
Mailing address
1845 PRECINCT LINE RD, STE 209, HURST, TX 76054-3109
(817) 336-4638
(817) 336-7637
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
M3746
TX
2085R0202X
Diagnostic Radiology Physician
Primary
M3746
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185923303
—
TX
01
—
P00463016
MEDICARE RR
TX
Enumeration date
01/16/2007
Last updated
04/11/2019
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