Individual
SRINIVASA A REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5026 POOL ROAD, DENISON, TX 75020-4595
(903) 465-3624
(903) 465-3973
Mailing address
5012 S US HIGHWAY 75 STE 300, ATT.BILLING, DENISON, TX 75020-4589
(903) 465-3624
(903) 465-3973
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L2091
TX
207RC0000X
Cardiovascular Disease Physician
L2091
TX
207RI0011X
Interventional Cardiology Physician
Primary
L2091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181383403
—
TX
05
—
200032000A
—
OK
01
—
22577
MEDICAL LICENSE
OK
Enumeration date
06/23/2005
Last updated
10/09/2017
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