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Contact Information

SREEDHAR POLAVARAPU MD PA
2501 JIMMY JOHNSON BLVD
SUITE 207
PORT ARTHUR, TX77642
 Phone: 409-722-7500
 Fax: 409-293-4401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SREEDHAR POLAVARAPU MD PA

NPI # 1114009586
LBN Legal business name SREEDHAR POLAVARAPU MD PA
Authorized official SREEDHAR POLAVARAPU - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/19/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
TX License # L9431
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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