Healthcare Provider Details

I. General information

NPI: 1144413022
Provider Name (Legal Business Name): VEENADHARI T REDDY MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W MAGNOLIA AVE
FORT WORTH TX
76104-4501
US

IV. Provider business mailing address

950 W MAGNOLIA AVE
FORT WORTH TX
76104-4501
US

V. Phone/Fax

Practice location:
  • Phone: 817-336-5060
  • Fax: 817-336-1744
Mailing address:
  • Phone: 817-336-5060
  • Fax: 817-336-1744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: