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General NPI Number Information
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NPI Number | 1831197656
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Entity Type | Individual
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Provider Name | SRIDEVI PANCHAMUKHI M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 9925 GILLESPIE DR STE 2400
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City | PLANO
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State | TX
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Zip | 75025-1099
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Country | US
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Telephone | 972-905-1550
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Fax | 855-592-0913
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Provider Business Mailing Address
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Address Line | 6863 ELDARICA PL
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City | FRISCO
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State | TX
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Zip | 75034-8352
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Country | US
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Telephone | 469-325-1093
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Fax | 855-592-0913
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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 | R7081
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License Number State | TX
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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 | 036-101393
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License Number State | IL
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