Individual
RAGHURAM M REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1845 PRECINCT LINE RD STE 209, HURST, TX 76054-3109
(817) 336-4638
(817) 336-7637
Mailing address
1845 PRECINCT LINE RD STE 209, HURST, TX 76054-3109
(817) 336-4638
(817) 336-7637
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
200101991
MO
2085R0202X
Diagnostic Radiology Physician
21171
OK
2085R0202X
Diagnostic Radiology Physician
Primary
M4468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659318038
—
TX
01
—
P00379525
RR MEDICARE
TX
Enumeration date
06/02/2006
Last updated
09/12/2022
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