Srividya Thotakura, PAC

NPI #1407220353 in Herndon, Virginia

Provider Information

NPI Number: 1407220353
Entity Type: Individual
Name: Srividya Thotakura, PAC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Nov 16, 2015
Last Updated: Nov 16, 2015

Practice Location

Address: 13158 RUBY LACE CT
City: Herndon
State: Virginia
ZIP Code: 20171-2337
Phone: (612) 200-4585

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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