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NPI Code Detail

MEDICARE: RAGHUVEER M REDDY MD

MEDICARE: RAGHUVEER M 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
1207RG0100XGastroenterology PhysicianG7316TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28J3485OTHERTXBLUE CROSS

General Provider Information

NPI Number : 1619979101
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAGHUVEER M REDDY MD
Provider Business Mailing Address
First Line : 319 GASLIGHT BLVD
Second Line :
City : LUFKIN
State : TX
Zip : 75901
Country : US
Telephone Number : 936-634-3713
Fax Number : 936-634-8136
Provider Business Practice Location Address
First Line : 319 GASLIGHT BLVD
Second Line :
City : LUFKIN
State : TX
Zip : 75901-3124
Country : US
Telephone Number : 936-634-3713
Fax Number : 936-634-8136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 12/12/2012

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