| Neeraja Boddu Md Pa | |
|
2719 Northridge Dr Ste 107 Bedford TX 76021-4191 | |
| (817) 281-0210 | |
| (833) 909-2094 |
| Full Name | Neeraja Boddu Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2719 Northridge Dr Ste 107, Bedford, Texas |
| Authorized Official Name and Position | Neeraja Boddu (OWNER) |
| Authorized Official Contact | 8175764196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neeraja Boddu Md Pa Po Box 210602 Bedford TX 76095-7602 Ph: () - | Neeraja Boddu Md Pa 2719 Northridge Dr Ste 107 Bedford TX 76021-4191 Ph: (817) 281-0210 |
| NPI Number | 1316588361 |
|---|---|
| Provider Enumeration Date | 10/01/2019 |
| Last Update Date | 10/02/2023 |
| Medicare PECOS PAC ID | 9335573831 |
|---|---|
| Medicare Enrollment ID | O20191216001331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316588361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Neeraja J Boddu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356554281 PECOS PAC ID: 8820316276 Enrollment ID: I20191216001856 |
| Provider Name | Anija Poudel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114650884 PECOS PAC ID: 2769848449 Enrollment ID: I20230523000915 |
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