Healthcare Provider Details

I. General information

NPI: 1821094335
Provider Name (Legal Business Name): GNANA SUMATHI REDDY NAINI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 VILLAGE DR STE C
MURPHY TX
75094-4650
US

IV. Provider business mailing address

416 VILLAGE DR STE C
MURPHY TX
75094-4650
US

V. Phone/Fax

Practice location:
  • Phone: 972-325-8060
  • Fax: 972-430-7818
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberH6902
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberH6902
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: