Individual
MARK ANTHONY REDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BOULEVARD, HOUSE STAFF & GME, DALLAS, TX 75390-9257
(214) 645-8995
Mailing address
P.O. BOX 845347, HOUSE STAFF & GME, DALLAS, TX 75284-5347
(214) 590-8058
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
N1097
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
N1097
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP3-0029592
INSTITUTIONAL PERMIT
—
Enumeration date
06/13/2007
Last updated
08/22/2018
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