Individual
MARYADA SRINIVAS REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
310 E HIGHWAY 67, DUNCANVILLE, TX 75137-4159
(972) 283-2389
(972) 283-2473
Mailing address
310 E HIGHWAY 67, DUNCANVILLE, TX 75137-4159
(972) 283-2389
(972) 283-2473
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
L4103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157739701
—
TX
05
—
157739702
—
TX
01
—
8G3321
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/05/2006
Last updated
08/18/2008
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