Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1700204690 Individual Practitioner Male Practitioner

Dr. Phani Bodavula , MD

Pediatrics • Garland, TX

Professional Overview & Biography Verified Profile Summary

Dr. Phani Bodavula, MD is a registered healthcare professional specializing in Pediatrics in Garland, TX. Practice services are available at 6448 BROADWAY BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6448 Broadway Blvd

Garland, TX 75043

Telephone 9722168500
Fax 9722168521
Associated Practice Facility / Clinic
🏢 Jyoti Jain, Md, Pa Facility NPI 1336417039

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Garland, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.0 Yrs
Regional Practice Density
34 Specialists

Practicing in Garland, TX (5841 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-09-20
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License TX R5085

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Sreevani Bodavula , APRN, FNP-C

Nurse Practitioner - Family

NPI 1831978394

Advanced Practice Registered Nurse, Family Nurse Practitioner (Certified)

Dr. Jyoti Jain , MD

Pediatrics - Adolescent Medicine

NPI 1932111945

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

19 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2025

Pediatrics (License #R5085 in TX)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Pediatrics (License #67368 in WI)

📍
Updated Practice Location August 05, 2021

Registered at 6448 BROADWAY BLVD, GARLAND, TX 75043 (Tel: 9722168500)

📍
Updated Business Mailing Address August 05, 2021

Registered at 6448 BROADWAY BLVD, GARLAND, TX 750435943 (Tel: 9722168500)

📍
Updated Practice Location April 20, 2020

Registered at 4925 MARCUS AVE APT 3114, ADDISON, TX 750016183 (Tel: 3146205823)

📍
Updated Business Mailing Address April 20, 2020

Registered at 4925 MARCUS AVE APT 3114, ADDISON, TX 750016183 (Tel: 3146205823)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 20, 2020

Pediatrics (License #R5085 in TX)

📍
Updated Practice Location June 20, 2018

Registered at 3821 SPRING ST, MOUNT PLEASANT, WI 53405 (Tel: (262) 687-3333)

NPI Profile Active September 11, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 11, 2017

Registered at 3821 SPRING ST, MOUNT PLEASANT, WI 534051667 (Tel: (262) 687-3333)

📍
Updated Business Mailing Address September 11, 2017

Registered at 3821 SPRING ST, MOUNT PLEASANT, WI 534051667 (Tel: (262) 687-3333)

👤
Provider Name / Credentials Updated September 11, 2017

Recorded as PHANI BODAVULA, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2017

Pediatrics (License #67368 in WI)

NPI Profile Active March 28, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location March 28, 2014

Registered at 201 LYONS AVE, NEWARK, NJ 071122027 (Tel: 9739267471)

📍
Updated Business Mailing Address March 28, 2014

Registered at 201 LYONS AVE, NEWARK, NJ 071122027 (Tel: 9739267471)

👤
Provider Name / Credentials Updated March 28, 2014

Recorded as PHANI BODAVULA, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 28, 2014

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 28, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Phani Bodavula. Be the first to share your experience!

Sign in to leave a review for Dr. Phani Bodavula

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1700204690
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 28, 2014
Last Update: September 20, 2025
Sole Proprietor: No

Mailing Address

6448 Broadway Blvd

Garland, TX 750435943

Phone: 9722168500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.