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General NPI Number Information
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NPI Number | 1336267871
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Entity Type | Individual
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Provider Name | DR. MADHURI M. SOPIRALA
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 6201 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-0560
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Country | US
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Telephone | 214-633-5555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 845347 CENTRAL CREDENTIALING
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City | DALLAS
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State | TX
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Zip | 75284-7208
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Country | US
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Telephone | 469-291-3363
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Fax |
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 35085766
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | R6912
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License Number State | TX
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