Individual
DR. PAVAN DEVULAPALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4511 NW LOOP 410, SUITE 104, SAN ANTONIO, TX 78229-5124
(210) 614-7900
(210) 615-1211
Mailing address
PO BOX 504152, SAINT LOUIS, MO 63150-4152
(210) 212-8622
(210) 212-9197
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P9550
TX
207RN0300X
Nephrology Physician
Primary
P9550
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337482901
—
TX
Enumeration date
02/13/2009
Last updated
07/29/2019
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