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General NPI Number Information
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NPI Number | 1811457666
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Entity Type | Individual
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Provider Name | VISHWARADH GOLI REDDY
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 5266 INDEPENDENCE PKWY STE 150
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City | FRISCO
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State | TX
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Zip | 75035-5544
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Country | US
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Telephone | 469-287-9519
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Fax | 469-917-1368
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD.51106
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 125074574
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | U4612
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License Number State | TX
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