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General NPI Number Information
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NPI Number | 1548418130
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Entity Type | Organization
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Legal Business Name | VIJAYALAKSHMI M TAMMAREDDI MD PA
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 2965 HARRISON ST SUITE # 316
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City | BEAUMONT
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State | TX
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Zip | 77702-1100
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Country | US
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Telephone | 409-899-2332
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Fax | 409-923-1998
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Provider Business Mailing Address
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Address Line | 2965 HARRISON ST SUITE # 316
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City | BEAUMONT
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State | TX
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Zip | 77702-1100
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Country | US
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Telephone | 409-899-2332
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Fax | 409-923-1998
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BRANDA WILSON
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Credential |
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Telephone | 409-899-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | F4584
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License Number State | TX
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