Individual
SHANTI B REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1901 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 935-4000
(254) 935-4111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J0643
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
J0643
TX
208M00000X
Hospitalist Physician
J0643
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135133002
—
TX
Enumeration date
07/05/2006
Last updated
12/22/2021
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