MEDICARE: DR. SHAILESH 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
1	390200000X	Student in an Organized Health Care Education/Training Program	R300765115741	MI
2	2081N0008X	Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician	T0901	TX

General Provider Information

NPI Number	:	1467814350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAILESH REDDY MD

Provider Business Mailing Address
First Line	:	1600 BARTON SPRINGS RD UNIT 5201
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-1285
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4705 SPICEWOOD SPRINGS RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8402
Country	:	US
Telephone Number	:	512-920-0140
Fax Number	:

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

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	11/10/2025

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