Provider Demographics
NPI:1124021480
Name:GANDHI, DEENA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEENA
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MD
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 17643
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7643
Mailing Address - Country:US
Mailing Address - Phone:281-277-9137
Mailing Address - Fax:281-277-9141
Practice Address - Street 1:56 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4063
Practice Address - Country:US
Practice Address - Phone:281-277-9137
Practice Address - Fax:281-277-9141
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ41362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF88661Medicare UPIN
TX8D0309Medicare PIN