Provider Demographics
NPI:1497985188
Name:VADYALA, VIKRAM REDDY (MD)
Entity Type:Individual
Prefix:
First Name:VIKRAM
Middle Name:REDDY
Last Name:VADYALA
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 1:2002 N MIDLAND DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5598
Mailing Address - Country:US
Mailing Address - Phone:432-686-9999
Mailing Address - Fax:432-685-1700
Practice Address - Street 1:2002 N MIDLAND DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5598
Practice Address - Country:US
Practice Address - Phone:432-686-9999
Practice Address - Fax:432-685-1700
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2073207R00000X, 207RT0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology