Reddy, Vijayabhasker K

Reddy, Vijayabhasker K is an individual health care provider with primary practice located at 909 Aspen Ridge Dr , Southlake TX 76092-3840. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Reddy, Vijayabhasker K can be contacted via phone (817) 917-6647.

Contact Information

Primary practice address
909 Aspen Ridge Dr Southlake TX 76092-3840
Phone: (817) 917-6647
Fax: (870) 338-8239
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M5464 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E1310 Arkansas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X M5464 Texas

Profile Details

NPI number 1144287947
LBN Legal business name Reddy, Vijayabhasker K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated May 6th, 2024 - about 2 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 1144287947 NPPES
Arkansas MEDICAID 131920001

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