Individual
BHAVANA THOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 S 11TH ST STE 8290, PHILADELPHIA, PA 19107-4870
(215) 955-2370
Mailing address
4025 CENTENARY AVE, DALLAS, TX 75225-5430
(469) 307-7266
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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