Provider Demographics
NPI:1578004990
Name:ANIREDDY, NIDHISHA
Entity Type:Individual
Prefix:
First Name:NIDHISHA
Middle Name:
Last Name:ANIREDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15244 SADDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3453
Mailing Address - Country:US
Mailing Address - Phone:832-301-2346
Mailing Address - Fax:
Practice Address - Street 1:15244 SADDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3453
Practice Address - Country:US
Practice Address - Phone:832-301-2346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program