MEDICARE: DR. GURUNATH THOTA REDDY M.D.

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	207RG0100X	Gastroenterology Physician	H1192	TX

General Provider Information

NPI Number	:	1427042753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GURUNATH THOTA REDDY M.D.

Provider Business Mailing Address
First Line	:	275 LANTERN BEND DR
Second Line	:	STE 200
City	:	HOUSTON
State	:	TX
Zip	:	77090-2831
Country	:	US
Telephone Number	:	281-440-0101
Fax Number	:	281-440-6441

Provider Business Practice Location Address
First Line	:	275 LANTERN BEND DR
Second Line	:	STE 200
City	:	HOUSTON
State	:	TX
Zip	:	77090-2831
Country	:	US
Telephone Number	:	281-440-0101
Fax Number	:	281-440-6441

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	06/24/2013

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