Provider Demographics
NPI:1477672848
Name:REDDY, NAVEENA (MBA,MS,RD)
Entity Type:Individual
Prefix:
First Name:NAVEENA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MBA,MS,RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CENTRAL EXPY S STE 400
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8113
Mailing Address - Country:US
Mailing Address - Phone:214-620-6569
Mailing Address - Fax:
Practice Address - Street 1:700 CENTRAL EXPY S STE 400
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8113
Practice Address - Country:US
Practice Address - Phone:214-620-6569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
TXDT07116133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty