MEDICARE: DR. SARITHA CHARY-REDDY DDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	21184	TX

General Provider Information

NPI Number	:	1467526103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARITHA CHARY-REDDY DDS

Provider Business Mailing Address
First Line	:	2250 THOUSAND OAKS DR
Second Line	:	SUITE 120
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3989
Country	:	US
Telephone Number	:	210-496-6262
Fax Number	:	210-496-6263

Provider Business Practice Location Address
First Line	:	2250 THOUSAND OAKS DR
Second Line	:	SUITE 120
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3989
Country	:	US
Telephone Number	:	210-496-6262
Fax Number	:	210-496-6263

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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