MEDICARE: SANJANA BENDI-CHENNUPATI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	V6262	TX

General Provider Information

NPI Number	:	1295475986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJANA BENDI-CHENNUPATI DO

Provider Business Mailing Address
First Line	:	PO BOX 733784
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-3784
Country	:	US
Telephone Number	:	682-885-6483
Fax Number	:	682-885-3113

Provider Business Practice Location Address
First Line	:	2800 CHERRY LN STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-3923
Country	:	US
Telephone Number	:	682-303-2800
Fax Number	:	682-303-2799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	08/27/2025

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