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BODAVULA PEDIATRICS PLLC
NPI 1366008294
Pediatrics in Garland, TX

Active since May 16, 2019CLIA 45D2222702 · Waiver
6448 BROADWAY BLVD, GARLAND, TX 75043(972) 216-8500(972) 216-8521 Get Directions Write a Review

NPPES record last updated: September 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 20, 2025, Aug 5, 2021, Apr 20, 2020 and 1 more (4 updates tracked since 2019).

About Bodavula Pediatrics Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BODAVULA PEDIATRICS PLLC (NPI 1366008294) is a healthcare organization registered as a pediatrics in Garland, Texas and active in the NPI registry since May 2019. The organization holds a CLIA Waiver certificate valid through April 29, 2027 and lists Phani Bodavula, Owner, as its authorized official.

NPPES Registry Identity

NPI1366008294
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBODAVULA PEDIATRICS PLLC
Location Address6448 BROADWAY BLVDGarland, TX 75043-7504
Mailing Address6448 Broadway BlvdGarland, TX 75043-5943 · (972) 216-8500 · Fax (972) 216-8521
Phone(972) 216-8500
Fax(972) 216-8521
Organization SubpartNo
Authorized OfficialPhani BodavulaOwner · (314) 620-5823
Enumeration DateMay 16, 2019
Last NPPES UpdateSeptember 20, 20254 updates tracked since enumeration
NPPES CertifiedSeptember 20, 2025
✔ NPI 1366008294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
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.
6448 BROADWAY BLVD, Garland, TX 75043
Open in Google Maps ↗

Other Identifiers 2

Medicaid32070567899TX
Other32070567899TX · Texas Payer No

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2222702

Bodavula Pediatrics PLLC · Garland, TX
Active · expires Apr 29, 2027
CLIA Number45D2222702
Laboratory TypePhysician Office
Certificate Effective DateApril 30, 2025
Certificate Expiration DateApril 29, 2027
Laboratory DirectorPhani Bodavula
Laboratory Phone(972) 216-8500
Laboratory LocationBodavula Pediatrics PLLC6448 Broadway Blvd, Garland, TX 75043
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JYOTI JAIN, MD, PA
Pediatrics
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
NORTH DALLAS PEDIATRICS ASSOCIATES PC
Pediatrics
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
DR. PHANI BODAVULA M.D.
Pediatrics
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
SREEVANI BODAVULA APRN, FNP-C
Nurse Practitioner (Family)
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500
DR. JYOTI JAIN M.D.
Pediatrics (Adolescent Medicine)
6448 BROADWAY BLVD
GARLAND, TX 75043
Dallas County (972) 216-8500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bodavula Pediatrics PLLC's NPI number?

The NPI number for Bodavula Pediatrics PLLC is 1366008294. It was assigned to this organization in the NPPES registry on May 16, 2019.

Where is Bodavula Pediatrics PLLC located?

Bodavula Pediatrics PLLC is located at 6448 Broadway Blvd, Garland, TX 75043. The listed phone number is (972) 216-8500.

What is Bodavula Pediatrics PLLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Bodavula Pediatrics PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2222702) is associated with this NPI, valid through April 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Bodavula Pediatrics PLLC accept?

Health plans from Molina Healthcare list Bodavula Pediatrics PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bodavula Pediatrics PLLC was last updated on September 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.