Reddy, Praveen Jada Kumar

Reddy, Praveen Jada Kumar is an individual health care provider with primary practice located at 5400 Kell West Blvd , Wichita Falls TX 76310-1610. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Medical Oncology, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Reddy, Praveen Jada Kumar can be contacted via phone (940) 691-8271.

Contact Information

Primary practice address
5400 Kell West Blvd Wichita Falls TX 76310-1610
Phone: (940) 691-8271
Fax: (940) 692-2042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X L9444 Texas
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X L9444 Texas

Profile Details

NPI number 1316988090
LBN Legal business name Reddy, Praveen Jada Kumar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated May 7th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316988090 NPPES
Texas Other 8R1532 BLUE CROSS OF TEXAS
Texas MEDICAID 168416901 BLUE CROSS OF TEXAS
Texas MEDICAID 168416902 BLUE CROSS OF TEXAS
Texas MEDICAID 200042170A BLUE CROSS OF TEXAS

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