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General NPI Number Information
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NPI Number | 1215153705
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Entity Type | Organization
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Legal Business Name | S B REDDY M.D.P.A.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 919 E 32ND ST
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City | AUSTIN
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State | TX
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Zip | 78705-2703
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Country | US
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Telephone | 512-476-7111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 81337
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City | AUSTIN
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State | TX
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Zip | 78708-1337
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Country | US
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Telephone | 512-636-9483
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SRINIVASA BAKKANNAGARI
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Credential | M.D.
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Telephone | 512-636-9483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | L1523
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License Number State | TX
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