Individual
DR. SRIPATHI R KETHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2821 E PRESIDENT GEORGE BUSH HWY, SUITE 205, RICHARDSON, TX 75082-4266
(972) 238-9696
(972) 238-9753
Mailing address
7610 N STEMMONS FWY STE 600, DALLAS, TX 75247-4228
(214) 689-5960
(469) 713-8084
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M6699
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186440701
—
TX
01
—
8A7898
BCBSTX
TX
Enumeration date
05/20/2006
Last updated
09/23/2020
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