Provider Demographics
NPI:1952493561
Name:SREEDEVI YERRAPRAGADA, MD, APMC
Entity Type:Organization
Organization Name:SREEDEVI YERRAPRAGADA, MD, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SREEDEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:YERRAPRAGADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-673-8320
Mailing Address - Street 1:1534 ELIZABETH AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101
Mailing Address - Country:US
Mailing Address - Phone:318-673-8320
Mailing Address - Fax:318-673-8370
Practice Address - Street 1:1534 ELIZABETH AVENUE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101
Practice Address - Country:US
Practice Address - Phone:318-673-8320
Practice Address - Fax:318-673-8370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CD18Medicare PIN