MEDICARE: MR. PRAVEEN D REDDY R.PH

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	183500000X	Pharmacist	36577	TX

General Provider Information

NPI Number	:	1164769493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PRAVEEN D REDDY R.PH

Provider Business Mailing Address
First Line	:	6517 CHASE OAKS BLVD STE 101
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75023-2309
Country	:	US
Telephone Number	:	972-999-1748
Fax Number	:

Provider Business Practice Location Address
First Line	:	6517 CHASE OAKS BLVD STE 101
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75023-2309
Country	:	US
Telephone Number	:	972-999-1748
Fax Number	:

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

Provider Enumeration Date	:	01/07/2013
Last Update Date	:	06/03/2026

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