Basic Information
| Provider Information | |||||||||
| NPI: | 1437414620 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VEERAM REDDY | ||||||||
| FirstName: | RAVINDRANATH REDDY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5310 CARNABY ST | ||||||||
| Address2: | APT 335 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750383193 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8105150445 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1012 E ENNIS AVE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | ENNIS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728752501 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2012 | ||||||||
| LastUpdateDate: | 09/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 28186 | TX | Y | Dental Providers | Dentist | General Practice |
No ID Information.