Individual
DAYAKAR KAMJULA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(817) 250-2000
Mailing address
6716 PALERMO TRL, LEWISVILLE, TX 75077-8505
(607) 377-4573
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
242095
NY
207R00000X
Internal Medicine Physician
Primary
U5498
TX
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
242095
NY
208M00000X
Hospitalist Physician
242095
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02830106
—
NY
05
—
103154200
—
PA
Enumeration date
11/06/2006
Last updated
04/03/2024
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