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General NPI Number Information
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NPI Number | 1336104017
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Entity Type | Individual
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Provider Name | SURAPUREDDY SEETHARAM REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 1821 S SESAME SQ SUITE:8
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City | HARLINGEN
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State | TX
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Zip | 78550-9288
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Country | US
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Telephone | 956-425-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 106 PLUMOSA CT
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City | HARLINGEN
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State | TX
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Zip | 78552-6633
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Country | US
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Telephone | 956-364-0700
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L0535
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License Number State | TX
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