Provider Demographics
NPI:1447328828
Name:PAMULAPARTHY, SMITHA REDDY (MD)
Entity type:Individual
Prefix:
First Name:SMITHA
Middle Name:REDDY
Last Name:PAMULAPARTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3571 W WHEATLAND RD
Mailing Address - Street 2:# 101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3461
Mailing Address - Country:US
Mailing Address - Phone:972-274-5555
Mailing Address - Fax:972-274-5663
Practice Address - Street 1:3571 W WHEATLAND RD
Practice Address - Street 2:# 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3461
Practice Address - Country:US
Practice Address - Phone:972-274-5555
Practice Address - Fax:972-274-5663
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96733208M00000X
TXR0091207RN0300X
IL036129479207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A967330Medicaid
CA00A967330Medicare PIN