Provider Demographics
NPI:1184663221
Name:REDDY, SREELATHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SREELATHA
Middle Name:
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 1:7737 SOUTHWEST FWY
Mailing Address - Street 2:SUITE # 968
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1807
Mailing Address - Country:US
Mailing Address - Phone:713-773-1800
Mailing Address - Fax:713-773-1809
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:SUITE # 968
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-773-1800
Practice Address - Fax:713-773-1809
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1436207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144905001Medicaid
TX8809M0Medicare ID - Type Unspecified
TX144905001Medicaid