Active NPI
Shyam Sunder Reddy Mali
- Physical Therapist
- Allen, TX
National Provider Identifier
1154804946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1204912
- Practice address
- 1090 W Exchange Pkwy Apt 8311
Allen, TX 75013-7101 - Phone
- (972) 746-8070
- NPI assigned
- Sep 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1204912 | TX | Primary |
Addresses
Primary practice location
1090 W Exchange Pkwy Apt 8311
Allen, TX 75013-7101
Mailing address
1090 W Exchange Pkwy Apt 8311
Allen, TX 75013-7101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1204912 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536364800000",
"number": "1154804946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1090 W EXCHANGE PKWY APT 8311",
"city": "ALLEN",
"state": "TX",
"postal_code": "750137101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1090 W EXCHANGE PKWY APT 8311",
"city": "ALLEN",
"state": "TX",
"postal_code": "750137101",
"telephone_number": "972-746-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALI",
"first_name": "SHYAM SUNDER",
"middle_name": "REDDY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-08",
"last_updated": "2018-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1204912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.