| Mahesh Kottapalli, M.d., P.a. | |
|
2727 Bolton Boone Dr Suite109 Desoto TX 75115-2019 | |
| (972) 283-2370 | |
| (972) 296-0311 |
| Full Name | Mahesh Kottapalli, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2727 Bolton Boone Dr, Desoto, Texas |
| Authorized Official Name and Position | Mahesh Babu Kottapalli (PRESIDENT) |
| Authorized Official Contact | 9722832370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahesh Kottapalli, M.d., P.a. 2727 Bolton Boone Dr Suite109 Desoto TX 75115-2019 Ph: (972) 283-2370 | Mahesh Kottapalli, M.d., P.a. 2727 Bolton Boone Dr Suite109 Desoto TX 75115-2019 Ph: (972) 283-2370 |
| NPI Number | 1093020620 |
|---|---|
| Provider Enumeration Date | 08/06/2010 |
| Last Update Date | 08/06/2010 |
| Medicare PECOS PAC ID | 7214097989 |
|---|---|
| Medicare Enrollment ID | O20081125000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093020620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M1846 (Texas) | Secondary |
| 207RI0200X | Internal Medicine - Infectious Disease | M1846 (Texas) | Primary |
| Provider Name | Mahesh Babu Kottapalli |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245252733 PECOS PAC ID: 7810915402 Enrollment ID: I20051102000613 |
| Provider Name | Yashwanth Jasti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871890616 PECOS PAC ID: 1153580915 Enrollment ID: I20150220001936 |
| Provider Name | Prasanthi Jasty |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1295993434 PECOS PAC ID: 9638230188 Enrollment ID: I20150401001098 |
| Provider Name | Jaina V Abraham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508288184 PECOS PAC ID: 7315232709 Enrollment ID: I20160824001963 |
| Provider Name | Brielle Maranne Almendariz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003374174 PECOS PAC ID: 6608118203 Enrollment ID: I20190501001426 |
| Provider Name | Melissa Nicole Stoup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467003855 PECOS PAC ID: 5092149427 Enrollment ID: I20191218000903 |
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