Provider Demographics
NPI:1700316247
Name:RAVINDER G REDDY DPM PLLC
Entity Type:Organization
Organization Name:RAVINDER G REDDY DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:409-767-3330
Mailing Address - Street 1:3136 HORIZON RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-7808
Mailing Address - Country:US
Mailing Address - Phone:972-463-1253
Mailing Address - Fax:972-463-1185
Practice Address - Street 1:3136 HORIZON RD STE 120
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7808
Practice Address - Country:US
Practice Address - Phone:972-463-1253
Practice Address - Fax:972-463-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty