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General NPI Number Information
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NPI Number | 1558355883
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Entity Type | Individual
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Provider Name | UDAYINI KODALI MD
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Gender | Female
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 920 MEDICAL PLAZA DR SUITE 290
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City | SHENANDOAH
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State | TX
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Zip | 77380-3260
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Country | US
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Telephone | 832-813-5755
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Fax | 832-813-8096
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Provider Business Mailing Address
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Address Line | PO BOX 131898
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City | THE WOODLANDS
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State | TX
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Zip | 77393-1898
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Country | US
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Telephone | 832-813-5755
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Fax | 832-813-8096
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | M0463
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License Number State | TX
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