Individual
DEEPIKA DEVALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 ROSALIND REDFERN GROVER PKWY, MIDLAND, TX 79701-5846
(432) 221-1111
(432) 682-2284
Mailing address
4214 ANDREWS HWY STE 240, MIDLAND, TX 79703-4817
(432) 686-6600
(432) 682-2284
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
Q6620
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10047729
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363331501
—
TX
05
—
363331502
—
TX
Enumeration date
07/01/2013
Last updated
07/29/2020
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