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General NPI Number Information
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NPI Number | 1194035188
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Entity Type | Individual
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Provider Name | SMITHA REDDY PATI MD
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Gender | Female
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 1305 AIRPORT FWY STE 220
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City | BEDFORD
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State | TX
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Zip | 76021-6606
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Country | US
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Telephone | 817-358-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 AIRPORT FWY STE 220
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City | BEDFORD
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State | TX
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Zip | 76021-6606
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Country | US
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Telephone | 817-358-5800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R9417
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License Number State | TX
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