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Individual

JAYASANKAR K REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4412 KELL BLVD, WICHITA FALLS, TX 76309-4719
(940) 716-0557
(940) 355-0028
Mailing address
4412 KELL BLVD, WICHITA FALLS, TX 76309-4719
(940) 716-0557
(940) 355-0028

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N6404
TX
207RN0300X
Nephrology Physician
Primary
N6404
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213626901
TX
05
213626902
TX
Enumeration date
06/05/2006
Last updated
02/06/2023
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