Provider Demographics
NPI:1801101118
Name:MAHESH KOTTAPALLI, M.D., P.A.
Entity type:Organization
Organization Name:MAHESH KOTTAPALLI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:KOTTAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-283-2370
Mailing Address - Street 1:2727 BOLTON BOONE DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2019
Mailing Address - Country:US
Mailing Address - Phone:972-283-2370
Mailing Address - Fax:972-296-0311
Practice Address - Street 1:151 RVG PKWY STE 101
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5241
Practice Address - Country:US
Practice Address - Phone:972-283-2370
Practice Address - Fax:972-296-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty