Provider Demographics
NPI:1346421807
Name:NEW BRAUNFELS OB GYN PA
Entity Type:Organization
Organization Name:NEW BRAUNFELS OB GYN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGAKRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-626-6810
Mailing Address - Street 1:2115 STEPHENS PL
Mailing Address - Street 2:SUITE 1210
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2132
Mailing Address - Country:US
Mailing Address - Phone:830-626-6810
Mailing Address - Fax:830-629-5001
Practice Address - Street 1:2115 STEPHENS PL
Practice Address - Street 2:SUITE 1210
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2132
Practice Address - Country:US
Practice Address - Phone:830-626-6810
Practice Address - Fax:830-629-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8486207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168987901OtherCOMMUNITY FIRST MEDICAID
TX0046MAOtherBCBS
TX168987901Medicaid
TX168987901OtherCOMMUNITY FIRST MEDICAID