Provider Demographics
NPI:1366557886
Name:REDDY, ARVIND C (MD)
Entity type:Individual
Prefix:
First Name:ARVIND
Middle Name:C
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:506 GRAHAM DR
Mailing Address - Street 2:100
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3346
Mailing Address - Country:US
Mailing Address - Phone:281-351-6464
Mailing Address - Fax:281-351-6476
Practice Address - Street 1:506 GRAHAM DR
Practice Address - Street 2:100
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3346
Practice Address - Country:US
Practice Address - Phone:281-351-6464
Practice Address - Fax:281-351-6476
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4301081685207R00000X
TXN4693207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217425201Medicaid