Individual
ANURADHA VASIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1936 AMELIA CT, HIV-AIDS CLINIC, DALLAS, TX 75235-7711
(214) 590-5637
(214) 590-2832
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
662751
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183107501
—
TX
01
—
8Y1606
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
01/23/2007
Last updated
09/03/2009
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