Individual
SHIRISHA PEDDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
11801 SOUTH FWY, BURLESON, TX 76028
(817) 568-5955
Mailing address
11801 SOUTH FWY, BURLESON, TX 76028-7021
(817) 568-5955
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.065420
IL
208M00000X
Hospitalist Physician
036143377
IL
208M00000X
Hospitalist Physician
Primary
R5622
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036143377
STATE LICENSE
IL
Enumeration date
09/20/2014
Last updated
01/11/2026
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