Provider Demographics
NPI:1750796009
Name:JANGANGARI, SWETHA REDDY (MD)
Entity type:Individual
Prefix:DR
First Name:SWETHA REDDY
Middle Name:
Last Name:JANGANGARI
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 1:3200 SAN MARINO DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8633
Mailing Address - Country:US
Mailing Address - Phone:832-540-4835
Mailing Address - Fax:
Practice Address - Street 1:801 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-8212
Practice Address - Country:US
Practice Address - Phone:432-685-0450
Practice Address - Fax:432-685-0459
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10050844390200000X
TXR2633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program