Organization
MDSA TEXAS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNITHA PUDHOTA MD (OWNER)
(972) 655-9294
Entity
Organization
Contact information
Practice address
2705 HOSPITAL BLVD, SUITE 100, GRAND PRAIRIE, TX 75051-0928
(972) 314-9900
(972) 314-9901
Mailing address
PO BOX 630066, IRVING, TX 75063-0100
(972) 655-9294
(972) 655-9294
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
10/24/2013
Last updated
11/19/2013
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