Organization
BALAKRISHNA REDDY MANGAPURAM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA TABOADA (OFFICE MANAGER)
(281) 364-6677
Entity
Organization
Contact information
Practice address
9004 FOREST XING, SUITE E, THE WOODLANDS, TX 77381-1197
(281) 364-6677
(281) 292-6379
Mailing address
9004 FOREST XING, SUITE E, THE WOODLANDS, TX 77381-1197
(281) 364-6677
(281) 292-6379
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J9189
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035975401
—
TX
Enumeration date
01/25/2011
Last updated
01/25/2011
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