NPIMap

Individual provider Active NPI

Subodh R Devabhaktuni, MD

  • Cardiovascular Disease Physician
  • Fort Worth, TX
National Provider Identifier
1144459686
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
V4363 Issued in TX
Practice address
1300 W Terrell Ave Ste 500
Fort Worth, TX 76104-2810
Phone
(817) 252-5000
Fax
(817) 252-5086
NPI assigned
Jul 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-12338 AR
Cardiovascular Disease Physician 207RC0000X V4363 TX Primary
Cardiovascular Disease Physician 207RC0000X E-12338 AR
Clinical Cardiac Electrophysiology Physician 207RC0001X E-12338 AR

Addresses

Primary practice location

1300 W Terrell Ave Ste 500
Fort Worth, TX 76104-2810

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

4301 W Markham St # 532
Little Rock, AR 72205-7101
Phone (501) 686-5311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190703000431 AR Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7719133370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101

Hospital & facility affiliations

  • University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016
  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • White County Medical Center Hospital, Searcy, AR, CCN 040014
  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Svia Professional, LLC Clinical Cardiac Electrophysiology Current Accepting new patients
University of Arkansas for Medical Sciences Internal Medicine CurrentSince Jul 22, 2019 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 22, 2019 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Current Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jul 22, 2019 Accepting new patients

Locations

1 Childrens Way
Ste 653
Little Rock, AR 72202

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

4301 W Markham St
#532
Little Rock, AR 72205
Phone (501) 686-5311

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1144459686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE STE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042810",
            "telephone_number": "817-252-5000",
            "fax_number": "817-252-5086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 532",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-5311",
            "fax_number": "501-686-6439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVABHAKTUNI",
        "first_name": "SUBODH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-12338",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "V4363",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E-12338",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "AR",
            "license": "E-12338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.