Provider Demographics
NPI:1780658708
Name:REDDY, HIMABINDU RAMASAHAYA (MD)
Entity Type:Individual
Prefix:
First Name:HIMABINDU
Middle Name:RAMASAHAYA
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 CLEARFORK MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3562
Mailing Address - Country:US
Mailing Address - Phone:817-336-7191
Mailing Address - Fax:
Practice Address - Street 1:5450 CLEARFORK MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-3562
Practice Address - Country:US
Practice Address - Phone:817-336-7191
Practice Address - Fax:817-419-8840
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2040207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183557103Medicaid
TX183557104Medicaid
TX183557105Medicaid
TX183557102Medicaid
TX183557102Medicaid
TX183557105Medicaid