| Srilatha A. Reddy, M.d., P.a | |
|
1302 Lane St Ste 300 Irving TX 75061-2257 | |
| (972) 870-0788 | |
| (972) 870-0393 |
| Full Name | Srilatha A. Reddy, M.d., P.a |
|---|---|
| Speciality | Family Medicine |
| Location | 1302 Lane St, Irving, Texas |
| Authorized Official Name and Position | Srilatha Arrem Reddy (PRESIDENT) |
| Authorized Official Contact | 9723424277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Srilatha A. Reddy, M.d., P.a 1302 Lane St Ste 300 Irving TX 75061-2257 Ph: (972) 870-0788 | Srilatha A. Reddy, M.d., P.a 1302 Lane St Ste 300 Irving TX 75061-2257 Ph: (972) 870-0788 |
| NPI Number | 1164525440 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 11/02/2012 |
| Medicare PECOS PAC ID | 1557329521 |
|---|---|
| Medicare Enrollment ID | O20041221001053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164525440 | NPI | - | NPPES |
| 146831601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Srilatha A Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942415930 PECOS PAC ID: 2466410436 Enrollment ID: I20041227000363 |
| Provider Name | Julius N Kibe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457626939 PECOS PAC ID: 9830320928 Enrollment ID: I20140403000739 |
| Provider Name | Ambreen A Alwani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578107744 PECOS PAC ID: 3779996780 Enrollment ID: I20210113000112 |
| Provider Name | Uchenna Okechukwu Aduba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275881591 PECOS PAC ID: 9537521273 Enrollment ID: I20230814000774 |
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