Bodavula Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BODAVULA PEDIATRICS PLLC

Practice address

6448 Broadway Blvd
Garland, TX 75043-7504

Phone

(972) 216-8500

Fax

(972) 216-8521

NPI assigned

May 16, 2019

Organization subpart

No

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

Authorized official

Name

Phani Bodavula, MDNPI 1700204690

Title

Owner

Phone

(314) 620-5823

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phani Bodavula, M.D.

  • Pediatrics Physician
  • Garland, TX
  • NPI 1700204690
  NPD Authorized official
• Sreevani Bodavula, APRN, FNP-C

  • Family Nurse Practitioner
  • Garland, TX
  • NPI 1831978394
  NPD (past)

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758326400000",
    "number": "1366008294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6448 BROADWAY BLVD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435943",
            "telephone_number": "972-216-8500",
            "fax_number": "972-216-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6448 BROADWAY BLVD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750437504",
            "telephone_number": "972-216-8500",
            "fax_number": "972-216-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODAVULA PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2025-09-20",
        "certification_date": "2025-09-20",
        "status": "A",
        "authorized_official_last_name": "BODAVULA",
        "authorized_official_first_name": "PHANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-620-5823",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32070567899",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PAYER NO",
            "identifier": "32070567899",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PHANIBODAVULA5@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL ADDRESS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMAIL",
            "address_1": "4925 Marcus Ave Apt 3114",
            "city": "Addison",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750016183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamila Aisha Blount, FNP-C
• Sharhonda Blue, PA-C
• Bluehaven Psychiatry PLLC
• Blueprints at Room for Change PLLC
• Carmen Blunt, DDS
• Phani Bodavula, M.D.
• Sreevani Bodavula, APRN, FNP-C
• Jillian M Boehm, PA-C
• Felicia Boggess
• Houston Bogus Jr., M.D.

• Pediatrics Physician in Garland, TX
• Providers in Garland, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.