Provider Demographics
NPI:1962964718
Name:REDDY, KRISHNA THEJA KAKARLA (MD)
Entity type:Individual
Prefix:
First Name:KRISHNA THEJA
Middle Name:KAKARLA
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 677080
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-7080
Mailing Address - Country:US
Mailing Address - Phone:515-633-3600
Mailing Address - Fax:515-633-3838
Practice Address - Street 1:5880 UNIVERSITY AVE STE 102
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8209
Practice Address - Country:US
Practice Address - Phone:515-633-3600
Practice Address - Fax:515-288-0840
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2025-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAMD-55008207RC0000X
CAA177851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine