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General NPI Number Information
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NPI Number | 1184930331
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Entity Type | Individual
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Provider Name | MINI SREEDEVI MD
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Gender | Female
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 10/29/2022
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Provider Practice Location Address
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Address Line | 2821 E PRESIDENT GEORGE BUSH HWY STE 207
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City | RICHARDSON
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State | TX
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Zip | 75082
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Country | US
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Telephone | 972-907-1280
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Fax | 972-907-1290
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Provider Business Mailing Address
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Address Line | 2821 E PRESIDENT GEORGE BUSH HWY STE 207
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City | RICHARDSON
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State | TX
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Zip | 75082-4277
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Country | US
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Telephone | 972-907-1280
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Fax | 972-907-1290
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036124963
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | Q9743
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License Number State | TX
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