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NPI Code Detail

MEDICARE: PUNAEPALLI SRIDHAR REDDY MD

MEDICARE: PUNAEPALLI SRIDHAR REDDY MD
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
1207L00000XAnesthesiology PhysicianM6357TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275528556
Entity Type Code : Individual
Provider Name (Legal Business Name) : PUNAEPALLI SRIDHAR REDDY MD
Provider Business Mailing Address
First Line : PO BOX 2129
Second Line :
City : ODESSA
State : TX
Zip : 79760-2129
Country : US
Telephone Number : 432-640-2408
Fax Number : 432-640-4606
Provider Business Practice Location Address
First Line : 500 W 4TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-5001
Country : US
Telephone Number : 432-640-4000
Fax Number : 432-640-2565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 07/21/2022

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Directions to “ PUNAEPALLI SRIDHAR REDDY MD” Practice Location

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