Provider Demographics
NPI:1033194717
Name:REDDY, INDRANI N (MD)
Entity Type:Individual
Prefix:DR
First Name:INDRANI
Middle Name:N
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3537 S INTERSTATE 35 E
Mailing Address - Street 2:SUITE 214
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6800
Mailing Address - Country:US
Mailing Address - Phone:940-320-2745
Mailing Address - Fax:940-565-1215
Practice Address - Street 1:3537 S INTERSTATE 35 E
Practice Address - Street 2:SUITE 214
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6800
Practice Address - Country:US
Practice Address - Phone:940-320-2745
Practice Address - Fax:940-565-1215
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0234207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171236601Medicaid
TX171236602Medicaid
TXI27411Medicare UPIN
TX171236602Medicaid