Individual
DIVYA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 CARLOS G PARKER BLVD NW STE 108, TAYLOR, TX 76574-7059
(254) 978-5928
Mailing address
401 WESTINGHOUSE RD APT 10108, GEORGETOWN, TX 78626-5617
(612) 512-3963
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41675
TX
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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