Individual
DR. PRAVEEN JADA KUMAR REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 10TH ST, WICHITA FALLS, TX 76301-4307
(940) 764-5920
(940) 764-5921
Mailing address
PO BOX 9261, WICHITA FALLS, TX 76308-9261
(940) 764-7230
(940) 764-7255
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
L9444
TX
207RX0202X
Medical Oncology Physician
L9444
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168416901
—
TX
05
—
168416902
—
TX
05
—
200042170A
—
OK
01
—
8R1532
BLUE CROSS OF TEXAS
TX
Enumeration date
06/10/2006
Last updated
02/27/2026
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