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Contact Information

PHANI BODAVULA, MD
6448 BROADWAY BLVD
GARLAND, TX75043
 Phone: 972-216-8500
 Fax: 972-216-8521
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PHANI BODAVULA · (Male)

NPI # 1700204690
Status Active
Credentials MD
Entity Individual
Enumeration date 03/28/2014
Last updated 09/20/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • TX License # R5085
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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