MEDICARE: DR. INDRANI N REDDY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	M0234	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033194717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INDRANI N REDDY MD

Provider Business Mailing Address
First Line	:	3537 S INTERSTATE 35 E
Second Line	:	SUITE 214
City	:	DENTON
State	:	TX
Zip	:	76210-6800
Country	:	US
Telephone Number	:	940-320-2745
Fax Number	:	940-565-1215

Provider Business Practice Location Address
First Line	:	3537 S INTERSTATE 35 E
Second Line	:	SUITE 214
City	:	DENTON
State	:	TX
Zip	:	76210-6800
Country	:	US
Telephone Number	:	940-320-2745
Fax Number	:	940-565-1215

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	05/28/2014

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