Provider Demographics
NPI:1427042753
Name:REDDY, GURUNATH THOTA (MD)
Entity Type:Individual
Prefix:DR
First Name:GURUNATH
Middle Name:THOTA
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 LANTERN BEND DR
Mailing Address - Street 2:STE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2831
Mailing Address - Country:US
Mailing Address - Phone:281-440-0101
Mailing Address - Fax:281-440-6441
Practice Address - Street 1:275 LANTERN BEND DR
Practice Address - Street 2:STE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2831
Practice Address - Country:US
Practice Address - Phone:281-440-0101
Practice Address - Fax:281-440-6441
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1192207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E03436Medicare UPIN
TX824740Medicare ID - Type Unspecified