Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | K3420 | TX |
NPI | 1013020403 |
---|---|
Provider Name | Dr. Anugu Bhooma Reddy |
First Address | Waco, TX 76712-8512 |
Second Address | Waco, TX 76711-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |