| Organization Name: | SURESH N. GADASALLI,M.D.,P.A. |
| NPI Number: | 1912028010 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SOWJANYA SUDESH (ADMINISTRATOR) |
| Mailing Address: | 1940 E 42nd St Odessa |
| State: | TX US |
| Postal Code: | 797625840 |
| Phone Number: | 4325506464 |
| Fax Number: | 4325526773 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 06/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |