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Individual

DR. DEEPA VASIREDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
7053 JOHNSTON ST, LAFAYETTE, LA 70503-6305
(337) 210-5043
(337) 408-8578
Mailing address
401 YOUNGSVILLE HWY, SUITE 100, LAFAYETTE, LA 70508-5173
(337) 330-0031
(337) 330-0059

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
207937
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2398261
LA
Enumeration date
07/27/2012
Last updated
03/30/2017
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