Provider Demographics
NPI:1922045780
Name:REDDY, TEKULAPALLI ANANTH (MD)
Entity Type:Individual
Prefix:DR
First Name:TEKULAPALLI
Middle Name:ANANTH
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 1:2105 W LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5919
Mailing Address - Country:US
Mailing Address - Phone:432-685-0123
Mailing Address - Fax:432-685-0125
Practice Address - Street 1:2105 W LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5919
Practice Address - Country:US
Practice Address - Phone:432-685-0123
Practice Address - Fax:432-685-0125
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7896207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00MR422OtherBLUE CROSS/BLUESHIELD TX
TXMR42Medicare ID - Type Unspecified
TXD67588Medicare UPIN