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General NPI Number Information
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NPI Number | 1497921829
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Entity Type | Individual
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Provider Name | REVATHI ANGITAPALLI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 515 W MAYFIELD RD STE 102
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City | ARLINGTON
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State | TX
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Zip | 76014-2084
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Country | US
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Telephone | 817-759-7000
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Fax | 817-759-7027
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Provider Business Mailing Address
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Address Line | 800 W MAGNOLIA AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-4611
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Country | US
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Telephone | 817-759-7000
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Fax | 817-759-7027
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | M7828
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License Number State | TX
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