Organization
DIVIJA NEUROLOGY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHUVANA PRASAD L MANDALAPU MD (OWNER/PRESIDENT)
(512) 617-1841
Entity
Organization
Contact information
Practice address
8700 MANCHACA RD, SUITE 205, AUSTIN, TX 78748-5371
(512) 617-1841
(512) 280-6750
Mailing address
8700 MANCHACA RD, SUITE 205, AUSTIN, TX 78748-5371
(512) 617-1841
(512) 280-6750
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K9606
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019NC
BCBS
TX
Enumeration date
06/17/2006
Last updated
06/30/2009
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