MEDICARE: MR. NARESH KUMAR VASIREDDY PA-C

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	363A00000X	Physician Assistant	PA18543	TX

General Provider Information

NPI Number	:	1891565248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NARESH KUMAR VASIREDDY PA-C

Provider Business Mailing Address
First Line	:	230 O CONNOR RIDGE BLVD STE 110
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-6513
Country	:	US
Telephone Number	:	214-666-6259
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 E PARK BLVD STE 106
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-8844
Country	:	US
Telephone Number	:	214-666-6259
Fax Number	:	972-724-0501

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

Provider Enumeration Date	:	01/08/2024
Last Update Date	:	02/19/2026

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