MEDICARE: SAMITHA 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	207RN0300X	Nephrology Physician	N7578	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720224249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMITHA REDDY MD

Provider Business Mailing Address
First Line	:	4708 ALLIANCE BLVD
Second Line	:	SUITE 600
City	:	PLANO
State	:	TX
Zip	:	75093-5340
Country	:	US
Telephone Number	:	469-467-0011
Fax Number	:	469-467-4923

Provider Business Practice Location Address
First Line	:	5236 W UNIVERSITY DR STE 4200
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-8127
Country	:	US
Telephone Number	:	214-544-9590
Fax Number	:	214-544-9595

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

Provider Enumeration Date	:	01/05/2009
Last Update Date	:	07/13/2020

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