Basic Information
| Provider Information | |||||||||
| NPI: | 1013143122 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KANMANTHA REDDY | ||||||||
| FirstName: | ARUN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7500 MERCY RD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681242319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023985880 | ||||||||
| FaxNumber: | 4023986716 | ||||||||
| Practice Location | |||||||||
| Address1: | 6410 FANNIN STREET | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770305389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257211 | ||||||||
| FaxNumber: | 7135122245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2009 | ||||||||
| LastUpdateDate: | 06/27/2018 | ||||||||
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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 | 207RC0000X | R3118 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 390200000X | R3118 | TX | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RI0011X | 29697 | NE | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RI0011X | MD-42641 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.