Provider Demographics
NPI:1467535484
Name:REDDY, SASHIDHAR NARAPA (MD)
Entity Type:Individual
Prefix:DR
First Name:SASHIDHAR
Middle Name:NARAPA
Last Name:REDDY
Suffix:
Gender:M
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:777 WALTER REED BLVD
Practice Address - Street 2:#201
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5788
Practice Address - Country:US
Practice Address - Phone:972-272-3417
Practice Address - Fax:972-487-1749
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4924207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184706302Medicaid
TX184706301Medicaid
TX8W1138OtherBLUECROSS BLUESHIELD
TX8J4480Medicare PIN
TXP00380863Medicare PIN
TX184706302Medicaid
TX8W1138OtherBLUECROSS BLUESHIELD