Organization
SODHA MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRABHAV K TELLA M.D. (PRESIDENT)
(972) 956-5541
Entity
Organization
Contact information
Practice address
108 SAN GABRIEL DR, IRVING, TX 75039-3350
(972) 956-5541
Mailing address
405 STATE HIGHWAY 121 BYP, BUILDING A SUITE 150, LEWISVILLE, TX 75067-8214
(972) 956-5541
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
M2854
TX
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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