MEDICARE: POTLURI SERVICES LLC

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1730484767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POTLURI SERVICES LLC

Provider Business Mailing Address
First Line	:	4531 NEWCASTLE DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-8404
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 ALLIED DR
Second Line	:	THE HEART HOSPITAL BAYLOR PLANO
City	:	PLANO
State	:	TX
Zip	:	75093-5348
Country	:	US
Telephone Number	:	469-323-5050
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. SRINIVASA POTLURI
Credential	:	MD
Telephone Number	:	469-323-5050

Provider Enumeration Date	:	01/23/2011
Last Update Date	:	01/23/2011

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Directions to “POTLURI SERVICES LLC ” Practice Location

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