Organization
SITA M DEVULAPALLI, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SITA MAHALAKSHMI DEVULAPALLI MD (PRESIDENT)
(903) 234-9500
Entity
Organization
Contact information
Practice address
903 WALNUT HILL DR, SUITE 1, LONGVIEW, TX 75605-5062
(903) 234-9500
(903) 234-2360
Mailing address
903 WALNUT HILL DR, SUITE 1, LONGVIEW, TX 75605-5062
(903) 234-9500
(903) 234-2360
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
K4038
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012CA
BCBSTX
TX
05
—
029636001
—
TX
Enumeration date
04/02/2007
Last updated
07/26/2011
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