MEDICARE: DR. SMITHA REDDY PATI 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	207Q00000X	Family Medicine Physician	R9417	TX

General Provider Information

NPI Number	:	1194035188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SMITHA REDDY PATI MD

Provider Business Mailing Address
First Line	:	1305 AIRPORT FWY STE 220
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-6606
Country	:	US
Telephone Number	:	817-358-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1305 AIRPORT FWY STE 220
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-6606
Country	:	US
Telephone Number	:	817-358-5800
Fax Number	:

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

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	06/12/2025

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