Provider Demographics
NPI:1023081056
Name:REDDY, NAVEEN K (MD)
Entity type:Individual
Prefix:DR
First Name:NAVEEN
Middle Name:K
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 1:9705 TIMBER RIDGE PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-3138
Mailing Address - Country:US
Mailing Address - Phone:512-462-1936
Mailing Address - Fax:512-394-9388
Practice Address - Street 1:7900 FM 1826
Practice Address - Street 2:STE. 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-1407
Practice Address - Country:US
Practice Address - Phone:512-462-1936
Practice Address - Fax:512-394-9388
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8734174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG50571Medicare UPIN
TX8347J1Medicare ID - Type Unspecified