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Organization
PARAGON PRIMARY CARE PHYSICIANS, PA
Active
Organization
PARAGON PRIMARY CARE PHYSICIANS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PALLAVOLU N REDDY M.D. (MD)
(281) 579-3000
Entity
Organization
Contact information
Practice address
20911 KINGSLAND BLVD, SUITE 100, KATY, TX 77450-5548
(281) 579-3000
(281) 579-3001
Mailing address
20911 KINGSLAND BLVD, SUITE 100, KATY, TX 77450-5548
(281) 579-3000
(281) 579-3001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K8452
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096659002
—
TX
01
—
10031462
AMERIGROUP
TX
Enumeration date
02/22/2006
Last updated
08/10/2012
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