NPIMap

Organization Active NPI

Srilatha a. Reddy, M.D., P.a

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1164525440
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SRILATHA A. REDDY, M.D., P.A
Practice address
1302 Lane St
Ste 300
Irving, TX 75061-2257
Phone
(972) 870-0788
Fax
(972) 870-0393
NPI assigned
Sep 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Srilatha Arrem Reddy, M.DNPI 1942415930
Title
President
Phone
(972) 342-4277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1302 Lane St
Ste 300
Irving, TX 75061-2257

Mailing address

1302 Lane St
Ste 300
Irving, TX 75061-2257
Phone (972) 870-0788

Other identifiers 1

IdentifierTypeStateIssuer
146831601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221001053 TX Part B Supplier - Clinic/Group Practice 1557329521 Receives reassigned benefits from 2 practitioners
Practice locations: Irving, TX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

3600 Conflans Rd
Ste 100
Irving, TX 75061
Phone (972) 870-0788

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1164525440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 LANE ST",
            "address_2": "STE 300",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612257",
            "telephone_number": "972-870-0788",
            "fax_number": "972-870-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 LANE ST",
            "address_2": "STE 300",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612257",
            "telephone_number": "972-870-0788",
            "fax_number": "972-870-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRILATHA A. REDDY, M.D., P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SRILATHA",
        "authorized_official_middle_name": "ARREM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-342-4277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146831601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.