Provider Demographics
NPI:1043576218
Name:7872 INC.
Entity Type:Organization
Organization Name:7872 INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUPA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDDIREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-392-5974
Mailing Address - Street 1:2400 SUGAR CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2580
Mailing Address - Country:US
Mailing Address - Phone:214-334-6831
Mailing Address - Fax:
Practice Address - Street 1:615 CLINIC DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5172
Practice Address - Country:US
Practice Address - Phone:903-212-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty