Individual
DR. SRINIVAS KODALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3070 COLLEGE ST STE 301, BEAUMONT, TX 77701-4688
(409) 813-1686
(409) 813-3052
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
N1713
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202324401
—
TX
05
—
202324402
—
TX
01
—
8BZ885
BCBS
TX
01
—
P00725231
RAILROAD MEDICARE
TX
Enumeration date
04/27/2009
Last updated
06/27/2016
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