MEDICARE: SATISH PASALA MD

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	208M00000X	Hospitalist Physician	MD.204075	LA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	P4365	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01298831	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710177043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SATISH PASALA MD

Provider Business Mailing Address
First Line	:	929 HILLTOP DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5845
Country	:	US
Telephone Number	:	817-533-5233
Fax Number	:	817-533-5243

Provider Business Practice Location Address
First Line	:	929 HILLTOP DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5845
Country	:	US
Telephone Number	:	817-533-5233
Fax Number	:	817-533-5243

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

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	12/16/2020

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Directions to “ SATISH PASALA MD” Practice Location

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