Basic Information
| Provider Information | |||||||||
| NPI: | 1750579389 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REDDY | ||||||||
| FirstName: | GAYATRI | ||||||||
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| Credential: | M. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2440 | ||||||||
| Address2: | |||||||||
| City: | WEATHERFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760867440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175991780 | ||||||||
| FaxNumber: | 8175991781 | ||||||||
| Practice Location | |||||||||
| Address1: | 713 E ANDERSON ST | ||||||||
| Address2: | |||||||||
| City: | WEATHERFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760865705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175991780 | ||||||||
| FaxNumber: | 8175991781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2007 | ||||||||
| LastUpdateDate: | 06/19/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | M5462 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | M5462 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.