Leena R. Kodali, M.D.
Individual provider Active NPI Geriatric Medicine (Internal Medicine) Physician · Navasota, TX
NPI 1306045679 · NPPES record last updated Feb 20, 2020
Key facts
- NPI
- 1306045679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- License
- Q9178 (TX)
- Practice address
- 8264 Highway 6 Loop
Navasota, TX 77868-3292 - Phone
- (979) 207-6100
- NPI assigned
- Jul 16, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160729000379 | TX | Practitioner - Internal Medicine |
0042370793 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health and Human Services Commission | Current |
Accepting new patients | |
| Health and Human Services Commission | Current |
Accepting new patients | |
| Health and Human Services Commission | Current | Accepting new patients | |
| Scott & White Hospital - Taylor | Past |
Accepting new patients | |
| Calvert Health Ventures Inc | Past | Accepting new patients |
Locations
2501 Maple St
Abilene, TX 79602
Phone (325) 692-4053
4001 Highway 36 S
Brenham, TX 77833
Phone (979) 277-1327
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | D67788 | MD | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | Q9178 | TX | Yes |
Addresses
Primary practice location
8264 Highway 6 Loop
Navasota, TX 77868-3292
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 415877600 | Medicaid | MD |
Other providers in Navasota, TX
- Brandon Jarvis
- Gregory Jelinek
- Pam L Johnson
- K&Jay Community Home LLC
- Katherine E. Blalock, M.D., P.a.
- Land of Milk and Honey Vegetable Farm, LLC
- Live Laugh Love PC LLC
- Luke P Scamardo II MD PA
- Crystal James Mable
- June Mabry
All providers in Navasota, TX · Geriatric Medicine (Internal Medicine) Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.