Provider Demographics
NPI:1194010512
Name:GANDHI, AVANTI LATTHE (MD)
Entity Type:Individual
Prefix:MRS
First Name:AVANTI
Middle Name:LATTHE
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AVANTI
Other - Middle Name:BHARAT
Other - Last Name:LATTHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4515 SETON CENTER PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5290
Mailing Address - Country:US
Mailing Address - Phone:512-504-5186
Mailing Address - Fax:
Practice Address - Street 1:6001 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6112
Practice Address - Country:US
Practice Address - Phone:512-504-5186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10041514207R00000X
CAA132598207R00000X
TXQ6627208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine