Organization
SRIDHAR P. REDDY, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRIDHAR P. REDDY MD PA (PRESIDENT)
(512) 474-6321
Entity
Organization
Contact information
Practice address
2911 MEDICAL ARTS ST STE 9B, AUSTIN, TX 78705-3302
(512) 474-6321
(512) 474-6324
Mailing address
2911 MEDICAL ARTS ST STE 9B, AUSTIN, TX 78705-3302
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J7639
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032QS
BLUE CROSS BLUE SHIELD
TX
01
—
10011874
AMERIGROUP PROVIDER ID
TX
01
—
10659947533
GREAT WEST HLTHCARE ID
TX
01
—
2669771
AETNA PROVIDER ID
TX
01
—
710200TX78705
BCBS OF MICHIGAN PROVI.ID
TX
01
—
DA2621
MCARE RR GROUP ID
TX
01
—
P00042032
MCARE RAILRD PROVID ID
TX
Enumeration date
06/01/2007
Last updated
03/21/2008
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