Pavan Pamadurthi M.D., P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

P5865 Issued in TX

Legal business name

PAVAN PAMADURTHI M.D., P.A.

Practice address

3447 Renner Rd Ste 120
Plano, TX 75074-0051

Phone

(469) 941-4546

Fax

(469) 941-4543

NPI assigned

Jan 22, 2015

Organization subpart

No

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

Authorized official

Name

Pavan Kumar Reddy Pamadurthi, M.D., P.A.NPI 1982835112

Title

Psychiatrist

Phone

(469) 941-4546

Specialties & licenses 1

Addresses

Other names 1

• Safe Haven Psychiatry Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 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

Locations

Practitioners 2

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

• Pavan Kumar Reddy Pamadurthi, M.D.

  • Psychiatry Physician
  • Temple, TX
  • NPI 1982835112
  Medicare reassignment NPD Authorized official
• Thanh Phan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Plano, TX
  • NPI 1083377568
  NPD

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1841689221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3447 RENNER RD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740051",
            "telephone_number": "469-941-4546",
            "fax_number": "469-941-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3447 RENNER RD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740051",
            "telephone_number": "469-941-4546",
            "fax_number": "469-941-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVAN PAMADURTHI M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "PAMADURTHI",
        "authorized_official_first_name": "PAVAN",
        "authorized_official_middle_name": "KUMAR REDDY",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "469-941-4546",
        "authorized_official_credential": "M.D., P.A."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "P5865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safe Haven Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Safe Haven Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Paul, PHARMD
• McCartney Paul, LPC
• Marisol B Pauling, CCC/SLP
• Lisa Paulsen, LCDC
• Lara Pavageau, MD
• Anna Pavlisova, LMFT-A
• Ethan Pavlovsky, DO
• Sarah N Payberah, M.D.
• Susan R Payberah, M.D.
• Emily Rae Payma, LCSW

• Psychiatry Physician in Plano, TX
• Providers in Plano, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.