SMITHA SYAMALA KOMATREDDY NPI 1174413470

NPI Information

  • NPI: 1174413470
  • Provider Name: SMITHA SYAMALA KOMATREDDY
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 823 IRA E WOODS AVE STE 200
    GRAPEVINE, TX
    ZIP 76051
  • Phone: (817) 722-6078

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NPI Details

Smitha Syamala Komatreddy is a psychiatric/mental health nurse practitioner in Grapevine, TX. Smitha Syamala Komatreddy NPI is 1174413470. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

823 IRA E WOODS AVE STE 200
GRAPEVINE, TX
ZIP 76051-096
Phone: (817) 722-6078

The NPI 1174413470 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2025 and was last updated on 7/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health1102099TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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