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Organization

FORNEY PEDIATRIC & MEDICAL CLINIC P.A.

Active
Other names
Forney Pediatric & Medical Clinic, P.A.
Organization subpart
No

Provider details

NPI number
Authorized official
JAYAPRAKASH NARAYAN REDDY MD (PRESIDENT)
(972) 552-3330
Entity
Organization

Contact information

Practice address
713 W BROAD ST, SUITE 100, FORNEY, TX 75126
(972) 552-3330
(972) 552-3303
Mailing address
713 W BROAD ST, SUITE 100, FORNEY, TX 75126
(972) 552-3330
(972) 552-3303

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G4198
TX
207R00000X
Internal Medicine Physician
G4198
TX
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
G2825
TX

Other

Enumeration date
12/22/2006
Last updated
11/14/2008
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