Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | L4669 | TX |
NPI | 1235199621 |
---|---|
Provider Name | Hari Reddy |
First Address | Allen, TX 75013-8000 |
Second Address | Allen, TX 75013-8000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I17543 | (02) | TX |