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Individual

DR. SUDHA TEERDHALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4700 N GALLOWAY AVE, MESQUITE, TX 75150-1516
(972) 686-6411
(972) 686-0594
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
K4266
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
040628201
TX
05
101119902
TX
01
8R1565
BLUE CROSS OF TEXAS
TX
Enumeration date
06/12/2006
Last updated
05/08/2008
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