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General NPI Number Information
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NPI Number | 1316988090
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Entity Type | Individual
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Provider Name | PRAVEEN JADA KUMAR REDDY MD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 1600 10TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4307
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Country | US
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Telephone | 940-764-5920
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Fax | 940-764-5921
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Provider Business Mailing Address
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Address Line | PO BOX 9261
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City | WICHITA FALLS
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State | TX
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Zip | 76308-9261
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Country | US
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Telephone | 940-764-7230
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Fax | 940-764-7255
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | L9444
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License Number State | TX
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