Organization
BOPPANA PRIMARY CARE CLINIC, PLLC
Active
Organization
BOPPANA PRIMARY CARE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SITA M BOPPANA M.D. (PRESIDENT)
(972) 644-1100
Entity
Organization
Contact information
Practice address
2460 N CENTRAL EXPY, SUITE 101, RICHARDSON, TX 75080-2713
(972) 644-1100
(972) 644-1107
Mailing address
PO BOX 830066, RICHARDSON, TX 75083-0066
(972) 644-1100
(972) 644-1107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151198201
—
TX
Enumeration date
03/29/2007
Last updated
11/05/2018
Update your record
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