Individual provider Active NPI

Madhu Potla, MD

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1366468944
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P7543 Issued in TX
Practice address
8787 N Macarthur Blvd
Suite No 120 B
Irving, TX 75063-5446
Phone
(864) 884-5116
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50946 MN
Family Medicine Physician 207Q00000X 7001 SD
Family Medicine Physician 207Q00000X P7543 TX Primary

Addresses

Primary practice location

8787 N Macarthur Blvd
Suite No 120 B
Irving, TX 75063-5446

Mailing address

8787 N Macarthur Blvd
Suite No 120 B
Irving, TX 75063-5446
Phone (864) 884-5116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1366468944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8787 N MACARTHUR BLVD",
            "address_2": "SUITE NO 120 B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635446",
            "telephone_number": "864-884-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8787 N MACARTHUR BLVD",
            "address_2": "SUITE NO 120 B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635446",
            "telephone_number": "864-884-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTLA",
        "first_name": "MADHU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "50946",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "7001",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P7543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.