Provider Demographics
NPI:1780892760
Name:REDDY, ANAND C (MD)
Entity type:Individual
Prefix:
First Name:ANAND
Middle Name:C
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N HANCOCK AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5140
Mailing Address - Country:US
Mailing Address - Phone:314-378-7270
Mailing Address - Fax:432-279-0904
Practice Address - Street 1:410 N HANCOCK AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5140
Practice Address - Country:US
Practice Address - Phone:432-279-0905
Practice Address - Fax:432-279-0904
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9287207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology