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General NPI Number Information
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NPI Number | 1912285644
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Entity Type | Individual
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Provider Name | PARDHA DEVAKI MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 3700 SE DODSON RD STE 2
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City | BENTONVILLE
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State | AR
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Zip | 72712-3728
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Country | US
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Telephone | 479-763-3501
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Fax | 479-763-3502
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Provider Business Mailing Address
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Address Line | 950 E STATE HIGHWAY 114 STE 200
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City | SOUTHLAKE
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State | TX
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Zip | 76092-5261
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Country | US
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Telephone | 214-424-2200
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Fax | 214-231-2159
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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 | E-10276
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License Number State | AR
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