Provider Demographics
NPI:1942732862
Name:JAMISETTI, SADHIKA MUDUNURI (MD)
Entity type:Individual
Prefix:MRS
First Name:SADHIKA
Middle Name:MUDUNURI
Last Name:JAMISETTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SADHIKA
Other - Middle Name:
Other - Last Name:MUDUNURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-7201
Mailing Address - Country:US
Mailing Address - Phone:214-891-6400
Mailing Address - Fax:
Practice Address - Street 1:8194 WALNUT HILL LN STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4316
Practice Address - Country:US
Practice Address - Phone:214-891-6400
Practice Address - Fax:214-891-6401
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU1928207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology