Healthcare Provider Details

I. General information

NPI: 1639599814
Provider Name (Legal Business Name): PRAVEENA K TALLAPUREDDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRAVEENA K LAKIREDDY MD

II. Dates (important events)

Enumeration Date: 04/26/2014
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 N CENTRAL EXPY STE 302
MCKINNEY TX
75071-8816
US

IV. Provider business mailing address

3801 N CENTRAL EXPY STE 302
MCKINNEY TX
75071-8816
US

V. Phone/Fax

Practice location:
  • Phone: 469-200-1151
  • Fax: 469-200-1153
Mailing address:
  • Phone: 469-200-1151
  • Fax: 469-200-1153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR2987
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberBP10050870
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: