Provider Demographics
NPI:1922725209
Name:REDDY, AUBREE SUDHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AUBREE
Middle Name:SUDHA
Last Name:REDDY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11136 CYPRESS TREE PT APT 108
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-7707
Mailing Address - Country:US
Mailing Address - Phone:214-604-9635
Mailing Address - Fax:
Practice Address - Street 1:3505 AUSTIN BLUFFS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5754
Practice Address - Country:US
Practice Address - Phone:800-888-9358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69873183500000X
CO23925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0023925OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES
TX69873OtherTEXAS STATE BOARD OF PHARMACY