Provider Demographics
NPI:1215317425
Name:DFW ENDOCRINOLOGY P.A.
Entity type:Organization
Organization Name:DFW ENDOCRINOLOGY P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:PRASANTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:TONDAPU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-930-4655
Mailing Address - Street 1:4505 BRENDA DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-1001
Mailing Address - Country:US
Mailing Address - Phone:469-930-4655
Mailing Address - Fax:
Practice Address - Street 1:1141 KELLER PKWY STE C
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-1628
Practice Address - Country:US
Practice Address - Phone:469-930-4655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2016-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5547261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty