MEDICARE: DR. VIRGINIA WATTS 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	207RR0500X	Rheumatology Physician	M4469	TX

General Provider Information

NPI Number	:	1477638153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIRGINIA WATTS REDDY MD

Provider Business Mailing Address
First Line	:	12740 HILLCREST RD STE 265
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2086
Country	:	US
Telephone Number	:	972-513-1410
Fax Number	:	469-565-9885

Provider Business Practice Location Address
First Line	:	12740 HILLCREST RD STE 265
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2086
Country	:	US
Telephone Number	:	972-513-1410
Fax Number	:	469-565-9885

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	01/24/2024

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