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Organization

MID VALLEY PEDIATRIC & ALLERGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. REGANT V REDDY MD (PHYSICIAN)
(956) 969-2609
Entity
Organization

Contact information

Practice address
1010 S AIRPORT DR, WESLACO, TX 78596-6647
(956) 969-2609
(956) 973-0413
Mailing address
1010 S AIRPORT DR, WESLACO, TX 78596-6647
(956) 969-2609
(956) 973-0413

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
F7583
TX
208000000X
Pediatrics Physician
K1893
TX
208000000X
Pediatrics Physician
K6219
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
081233101
TX
01
8546KI
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/26/2005
Last updated
02/04/2009
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