Healthcare Provider Details

I. General information

NPI: 1508113515
Provider Name (Legal Business Name): SRINIVAS RAMIREDDY M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SRINIVAS REDDY RAMI REDDY

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33663 BAYVIEW MEDICAL DR UNIT 2
LEWES DE
19958-1663
US

IV. Provider business mailing address

10720 BARKER CYPRESS RD STE 201
CYPRESS TX
77433-3144
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-9325
  • Fax: 302-644-7162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberC1-0027718
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036173115
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberR7090
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: