Healthcare Provider Details

I. General information

NPI: 1699607168
Provider Name (Legal Business Name): KRISHNA PABBA MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 PEAKS VIEW LN STE 110
CELINA TX
75009-5783
US

IV. Provider business mailing address

7008 VALOR TRL
TEMPLE TX
76502-2082
US

V. Phone/Fax

Practice location:
  • Phone: 817-874-1754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: KRISHNA PABBA
Title or Position: OWNER
Credential: MD
Phone: 817-874-1754