Provider Demographics
NPI:1700061819
Name:ALLAM, SRIDHAR REDDY (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SRIDHAR
Middle Name:REDDY
Last Name:ALLAM
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-8030
Mailing Address - Fax:956-362-8035
Practice Address - Street 1:1100 E DOVE AVE STE 200
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4681
Practice Address - Country:US
Practice Address - Phone:956-362-8030
Practice Address - Fax:956-362-8035
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8480207RN0300X, 204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX286395301Medicaid
TXTXB140870Medicare UPIN