| Infectious Diseases Consultants Of Texas Pllc | |
|
6551 Harris Pkwy Ste 110 Fort Worth TX 76132-6105 | |
| (817) 370-3444 | |
| (817) 984-4666 |
| Full Name | Infectious Diseases Consultants Of Texas Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6551 Harris Pkwy Ste 110, Fort Worth, Texas |
| Authorized Official Name and Position | Madhukanth Reddy (MD/OWNER) |
| Authorized Official Contact | 8173703444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Diseases Consultants Of Texas Pllc 8528 Davis Blvd Ste 134-359 North Richland Hills TX 76182-8367 Ph: () - | Infectious Diseases Consultants Of Texas Pllc 6551 Harris Pkwy Ste 110 Fort Worth TX 76132-6105 Ph: (817) 370-3444 |
| NPI Number | 1205487717 |
|---|---|
| Provider Enumeration Date | 09/25/2019 |
| Last Update Date | 09/25/2019 |
| Medicare PECOS PAC ID | 4880026087 |
|---|---|
| Medicare Enrollment ID | O20191108001122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205487717 | NPI | - | NPPES |
| 1356319990 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Madhukanth T. Reddy |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356319990 PECOS PAC ID: 3870682677 Enrollment ID: I20191108001209 |
| Provider Name | Roberta S Hardman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689313736 PECOS PAC ID: 1850762352 Enrollment ID: I20230120000118 |
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