Provider Demographics
NPI:1689255200
Name:MEDAPATI, VENKATRAMESH REDDY (DPM)
Entity type:Individual
Prefix:
First Name:VENKATRAMESH
Middle Name:REDDY
Last Name:MEDAPATI
Suffix:
Gender:M
Credentials:DPM
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4333 N JOSEY LN STE 206
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4631
Mailing Address - Country:US
Mailing Address - Phone:972-939-1757
Mailing Address - Fax:972-939-1682
Practice Address - Street 1:4333 N JOSEY LN STE 206
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4631
Practice Address - Country:US
Practice Address - Phone:972-939-1757
Practice Address - Fax:972-939-1682
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX692175213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery