Individual
DR. GAUTAM BHIMIDI REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3801 W 15TH ST, BLDG B, SUITE 320, PLANO, TX 75075-4737
(972) 985-8838
(844) 292-1457
Mailing address
3801 W 15TH ST STE 320, PLANO, TX 75075-7767
(972) 985-8838
(844) 292-1457
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
68545
GA
207RI0011X
Interventional Cardiology Physician
68545
GA
207RI0011X
Interventional Cardiology Physician
Primary
P3064
TX
207UN0901X
Nuclear Cardiology Physician
P3064
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
334371701
—
TX
Enumeration date
12/22/2007
Last updated
05/19/2023
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