Provider Demographics
NPI:1649271651
Name:SRINIVASA REDDY AALURI MD PA
Entity type:Organization
Organization Name:SRINIVASA REDDY AALURI MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVASA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:AALURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-633-9317
Mailing Address - Street 1:10555 VISTA DEL SOL DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7942
Mailing Address - Country:US
Mailing Address - Phone:915-633-9317
Mailing Address - Fax:915-633-8676
Practice Address - Street 1:10555 VISTA DEL SOL DR
Practice Address - Street 2:SUITE 115
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7942
Practice Address - Country:US
Practice Address - Phone:915-633-9317
Practice Address - Fax:915-633-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9590207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00983XMedicare PIN
I23998Medicare UPIN