Organization
7872 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUPA PEDDIREDDY M.D (PRESIDENT)
(214) 392-5974
Entity
Organization
Contact information
Practice address
615 CLINIC DR, LONGVIEW, TX 75605-5172
(903) 212-3105
Mailing address
2400 SUGAR CREEK CIR, LONGVIEW, TX 75605-2580
(214) 334-6831
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Enumeration date
04/02/2012
Last updated
09/16/2022
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