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Individual
VENKAT RAMANA THADAREDDY
Active
Individual
VENKAT RAMANA THADAREDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J9384
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131090608
—
TX
05
—
131090609
—
TX
01
—
1821185299
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC. - AGENCY NPI
TX
01
—
2872434-01
BVCAA DBA HEARNE CHC MEDICAID NUMBER
TX
01
—
67-1974
BVCAA, INC. DBA HEARNE CHC - FACILITY MEDICARE NUMBER
TX
Enumeration date
07/16/2006
Last updated
06/04/2020
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