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Individual

DR. MADHAVI GAVIRNENI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2909 MITCHELL BLVD, FT WORTH, TX 76105-4642
(817) 625-4254
(817) 740-8612
Mailing address
2909 MITCHELL BLVD, FORT WORTH, TX 76105-4642
(817) 625-4254
(817) 740-8612

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
53236
TN
208000000X
Pediatrics Physician
Primary
Q8890
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3714470
GROUP MEDICARE
TN
Enumeration date
06/27/2012
Last updated
04/16/2025
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