Provider Demographics
NPI:1326003641
Name:REDDY, SUNIL K (MD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:K
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1501 RIVER POINTE DR
Mailing Address - Street 2:STE 220
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2861
Mailing Address - Country:US
Mailing Address - Phone:936-756-8144
Mailing Address - Fax:936-494-1881
Practice Address - Street 1:1501 RIVER POINTE DR
Practice Address - Street 2:STE 220
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2861
Practice Address - Country:US
Practice Address - Phone:936-756-8144
Practice Address - Fax:936-494-1881
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2013-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ4984207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L50HOtherBLUE CROSS BLUE SHIELD
TX099310701Medicaid
TX100006999OtherRAILROAD MEDICARE
TXF68099Medicare UPIN
TX099310701Medicaid