Healthcare Provider Details

I. General information

NPI: 1730012899
Provider Name (Legal Business Name): VENUGOPAL REDDY VENNA PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6714 NICHOLAS TRL
SUGAR LAND TX
77479-4736
US

IV. Provider business mailing address

6714 NICHOLAS TRL
SUGAR LAND TX
77479-4736
US

V. Phone/Fax

Practice location:
  • Phone: 860-920-8102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: