Individual
KESHAVA CHERUKU REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3030 NORTH ST, SUITE 460, BEAUMONT, TX 77702-1433
(409) 892-6099
Mailing address
3030 NORTH ST, SUITE 460, BEAUMONT, TX 77702-1433
(409) 892-6099
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
J4983
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123480902
—
TX
01
—
86852N
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/06/2006
Last updated
09/13/2022
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