Bodhireddy, Surender R
Bodhireddy, Surender R is an individual health care provider with primary practice located at 3615 19Th St , Lubbock TX 79410-1203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Bodhireddy, Surender R can be contacted via phone (806) 744-1887.Contact Information
Primary practice address
3615 19Th St
Lubbock TX 79410-1203
Phone: (806) 744-1887
Fax: (806) 744-5545
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | K2185 | Texas |
Profile Details
| NPI number | 1558341602 |
|---|---|
| LBN Legal business name | Bodhireddy, Surender R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Sep 26th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558341602 | NPPES |
| Texas | Other | 220027645 | MC RR |
| Texas | MEDICAID | P084P0312 | MC RR |
| Texas | Other | 84P031 | MC RR |
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