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General NPI Number Information
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NPI Number | 1710198544
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Entity Type | Individual
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Provider Name | MADHAVI GADDAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/01/2018
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Provider Practice Location Address
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Address Line | 3300 COLORADO BLVD
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-488-4767
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Fax | 855-444-9702
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Provider Business Mailing Address
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Address Line | 2245 BRINKER RD
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City | DENTON
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State | TX
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Zip | 76208-6175
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Country | US
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Telephone | 940-488-4767
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Fax | 877-795-8358
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD27194
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | N3040
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License Number State | TX
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