Sodha Medical PA

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

M2854 Issued in TX

Legal business name

SODHA MEDICAL PA

Practice address

108 San Gabriel Dr
Irving, TX 75039-3350

Phone

(972) 956-5541

NPI assigned

Nov 4, 2011

Organization subpart

No

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

Authorized official

Name

Prabhav K Tella, M.D.

Title

President

Phone

(972) 956-5541

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1770860751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 STATE HIGHWAY 121 BYP",
            "address_2": "BUILDING A SUITE 150",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750678214",
            "telephone_number": "972-956-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SAN GABRIEL DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393350",
            "telephone_number": "972-956-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SODHA MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "TELLA",
        "authorized_official_first_name": "PRABHAV",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-956-5541",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TX",
            "license": "M2854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Irving, TX
• Providers in Irving, TX by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.