MEDICARE: SANGAMESHWAR P REDDY MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	L2589	TX

General Provider Information

NPI Number	:	1144622143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANGAMESHWAR P REDDY MD PA

Provider Business Mailing Address
First Line	:	9460 BELLA TERRA DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76126-1902
Country	:	US
Telephone Number	:	817-992-8880
Fax Number	:

Provider Business Practice Location Address
First Line	:	9460 BELLA TERRA DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76126-1902
Country	:	US
Telephone Number	:	817-992-8880
Fax Number	:

Authorized Official
Title or Position	:	GASTROENTEROLOGIST
Name	:	DR. SANGAMESHWAR P REDDY
Credential	:	M.D.
Telephone Number	:	817-992-8880

Provider Enumeration Date	:	09/22/2014
Last Update Date	:	09/22/2014

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