Provider Demographics
NPI:1013014224
Name:GUPTA HEADACHE & PAIN INSTITUTE, P.A.
Entity Type:Organization
Organization Name:GUPTA HEADACHE & PAIN INSTITUTE, P.A.
Other - Org Name:HEADACHE & PAIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-330-0961
Mailing Address - Street 1:4407 BEE CAVE RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6405
Mailing Address - Country:US
Mailing Address - Phone:512-330-0961
Mailing Address - Fax:512-330-0962
Practice Address - Street 1:4407 BEE CAVE RD
Practice Address - Street 2:SUITE 211
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6405
Practice Address - Country:US
Practice Address - Phone:512-330-0961
Practice Address - Fax:512-330-0962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK07942084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00319KMedicare PIN