DR. PRAVEEN JADA KUMAR REDDY (NPI# 1316988090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316988090 |
| Entity Type | Individual |
| Full Name | DR. PRAVEEN JADA KUMAR REDDY |
| Credential | MD |
| Practice Address |
5400 Kell West Blvd Wichita Falls TX 76310-1610 |
| Mailing Address |
Po Box 911230 Dallas TX 75391-1230 |
| Practice Telephone | 9406918271 |
| Practice Fax Number | 9406922042 |
| Mailing Telephone | 9729978000 |
| Mailing Fax Number | 9724379605 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2008-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
L9444 | TX | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
L9444 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200042170A | 05 | |
| TX | 168416902 | 05 | |
| TX | 168416901 | 05 | |
| TX | BLUE CROSS OF TEXAS | 8R1532 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255301842 | Praveen K Reddy | Orthopaedic Surgery | 721 River Dr., Suite B, Fort Bragg, CA 95437-5403 | 2006-01-25 |
| 1720060775 | Praveen B Reddy | Neurological Surgery | 1725 Se 28th Loop Ste 102, Ocala, FL 34471-5328 | 2005-11-16 |
| 1831539964 | Praveen A Reddy | Physician Assistant | 801 W 1st St, San Juan, TX 78589-2276 | 2013-07-03 |
| 1164769493 | Praveen D Reddy | Pharmacist | 5742 E Mockingbird Ln, Dallas, TX 75206-5422 | 2013-01-07 |
| 1184933319 | Praveen P Reddy | Pharmacist | 1 Millenium Dr, Willingboro, NJ 08046-1000 | 2010-10-05 |
| 1457663338 | Praveen K Reddy | Hospitalist | 267 Grant St, Bridgeport, CT 06610-2805 | 2010-07-08 |
| 1306028055 | Praveen Kumar Reddy | Physical Therapist | 16200 Hubbard Dr, Dearborn, MI 48126-4155 | 2007-12-04 |
| 1124093851 | Praveen C Reddy | Radiology | 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342-1606 | 2006-02-17 |
| Street Address |
5400 KELL WEST BLVD |
| City | WICHITA FALLS |
| State | TX |
| Zip Code | 76310-1610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104930312 | Mark S Lee | Radiology | 5400 Kell West Blvd, Texoma Cancer Center, Wichita Falls, TX 76310-1610 | 2006-08-18 |
| 1811910201 | Oncology Pharmacy Services Inc | Pharmacy | 5400 Kell West Blvd, Wichita Falls, TX 76310-1610 | 2006-07-26 |
| 1811931587 | Pasquale Robert Delizio | Internal Medicine | 5400 Kell West Blvd, Wichita Falls, TX 76310 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205329067 | Alesha Lynn Dean | Licensed Vocational Nurse | 6211 Talon Trail, Wichita Falls, TX 76310 | 2018-06-07 |
| 1962766741 | Kimberly D'anne Ravelo | Audiologist | 1 Burnside Drive, Wichita Falls, TX 76310 | 2012-06-27 |
| 1407142417 | Tobin Strom | Radiology | Texas Oncology, 5400 Kell West Blvd, Wichita Falls, TX 76310 | 2011-06-28 |
| 1386850055 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 6086 Kovarik Road, Wichita Falls, TX 76310 | 2007-05-16 |
| 1639391394 | Amy Louise Walmsley | Pharmacist | 1724 Woodridge Dr, Wichita Falls, TX 76310 | 2007-05-03 |
| 1619007416 | Stephanie Joy Postma | Specialist/Technologist | #1 West Medical Court, Wichita Falls, TX 76310 | 2007-03-07 |
| 1568518306 | Bestcare Health Services,inc | Home Health | 5800 Kell West Blvd, Suite 500, Wichita Falls, TX 76310 | 2007-01-26 |
| 1851453856 | Anthony Armando Denis Noya | Family Medicine | 8 Prairie Lace Court, Wichita Falls, TX 76310 | 2006-12-15 |
| 1467872127 | William Russell | Family Medicine | 4327 Barnett Rd, Wichita Falls, TX 76310 | 2014-04-22 |
| 1528297256 | Vanya David Wagler | Internal Medicine | 4327 Barnett Rd, Wichita Falls, TX 76310 | 2009-07-02 |
| Find all providers in zip 76310 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376521617 | Jagathi Challagalla | Internal Medicine | 5400 Kell Blvd, Wichita Falls, TX 76310-1610 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205399961 | Christus Health Ark-la-tex | Internal Medicine | 5002 Cowhorn Creek Rd Ste 3205, Texarkana, TX 75503-9766 | 2019-04-10 |
| 1861958704 | Thi of Texas At Samaritan Hospice LLC | Internal Medicine | 12001 N Central Expy Ste 550, Dallas, TX 75243-3943 | 2019-02-15 |
| 1417485822 | Ahmad Ghorab | Internal Medicine | 1515 Holcombe Blvd #1445, Houston, TX 77030 | 2017-05-30 |
| 1063952943 | Irfan Jawed Md Pllc | Internal Medicine | 4102 Woodlawn Avenue, Ste 160, Pasadena, TX 77504 | 2017-02-27 |
| 1366981615 | Houston Cancer Treatment Centers Pa. | Internal Medicine | 4102 Woodlawn Ave Ste 160, Pasadena, TX 77504-1922 | 2017-02-20 |
| 1508222720 | Maurizio Bendandi | Internal Medicine | 6722 Mimosa Ln, Dallas, TX 75230-5214 | 2016-01-04 |
| 1245642073 | Juan Francisco Garza | Internal Medicine | 3333 Bayshore Blvd Ste 320, Pasadena, TX 77504-1950 | 2014-05-28 |
| 1124463211 | Oluchi Oke | Internal Medicine | 1515 Holcombe Blvd Unit 463, Division of Cancer Medicine, Houston, TX 77030-4000 | 2013-05-03 |
| 1710229323 | Adaeze Nwosu- Iheme | Internal Medicine | 2700 Citizens Plz Ste 200, Victoria, TX 77901-5756 | 2013-03-21 |
| 1144570599 | Gummadi & Desai LLC | Internal Medicine | 2717 Michael Angelo Ste 302, Edinburg, TX 78539-1409 | 2012-09-13 |
| Find all providers with the same taxonomy | ||||
| City | WICHITA FALLS |
| Zip Code | 76310 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.