Individual
PAVAN SARIDENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
709 HOLLYBROOK DR STE 3401, LONGVIEW, TX 75605-2412
(903) 753-3331
(903) 247-0643
Mailing address
709 HOLLYBROOK DR STE 3401, LONGVIEW, TX 75605-2412
(903) 753-3331
(903) 247-0643
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L5127
TX
207RG0100X
Gastroenterology Physician
Primary
L5127
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154238310
—
TX
Enumeration date
06/17/2005
Last updated
06/28/2023
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