Individual
MADHAVI GADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3300 COLORADO BLVD, DENTON, TX 76210
(940) 488-4767
(855) 444-9702
Mailing address
2245 BRINKER RD, DENTON, TX 76208-6175
(940) 488-4767
(877) 795-8358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD27194
OR
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
N3040
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205024701
—
TX
05
—
205024702
—
TX
05
—
205024703
—
TX
01
—
P00691956
RAILROAD MEDICARE NUMBER
TX
01
—
P00838701
RAILROAD MEDICARE
TX
Enumeration date
05/24/2007
Last updated
08/01/2018
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