MEDICARE: DR. RAVINDRA REDDY GADAM M.D

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	208M00000X	Hospitalist Physician	P0384	TX
2	207Q00000X	Family Medicine Physician	P0384	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1356509004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVINDRA REDDY GADAM M.D

Provider Business Mailing Address
First Line	:	9405 KYLES STAKE RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78717-5554
Country	:	US
Telephone Number	:	850-320-2231
Fax Number	:

Provider Business Practice Location Address
First Line	:	790 GENERATIONS DR STE 205
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-0087
Country	:	US
Telephone Number	:	850-320-2231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	10/28/2025

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Directions to “ DR. RAVINDRA REDDY GADAM M.D” Practice Location

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