Provider Demographics
NPI:1255350294
Name:REDDY, KARUNAKAR POOLAPALLI (MD)
Entity type:Individual
Prefix:DR
First Name:KARUNAKAR
Middle Name:POOLAPALLI
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2101 S LOOP 336W
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3711
Mailing Address - Country:US
Mailing Address - Phone:936-441-8010
Mailing Address - Fax:936-760-2532
Practice Address - Street 1:2101 S LOOP 336W
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3711
Practice Address - Country:US
Practice Address - Phone:936-441-8010
Practice Address - Fax:936-760-2532
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1022207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085410101Medicaid
TX085410101Medicaid
TXB65068Medicare UPIN