Individual
DR. DHATRI KODALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 MEDICAL CENTER BLVD, WEBSTER, TX 77598-4219
(281) 332-7505
(281) 332-7616
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M8770
TX
207RH0003X
Hematology & Oncology Physician
18684
MN
207RH0003X
Hematology & Oncology Physician
Primary
M8770
TX
207RX0202X
Medical Oncology Physician
M8770
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193079401
—
TX
05
—
193079402
—
TX
05
—
193079403
—
TX
05
—
193079405
—
TX
01
—
8AQ003
BCBS
TX
01
—
P00662594
RAILROAD MEDICARE
TX
Enumeration date
08/09/2007
Last updated
05/08/2018
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