Provider Demographics
NPI:1235391418
Name:SEN-GUPTA, INDRANIL (MD)
Entity Type:Individual
Prefix:DR
First Name:INDRANIL
Middle Name:
Last Name:SEN-GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NEIL
Other - Middle Name:
Other - Last Name:SEN GUPTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4500 ELDORADO PKWY STE 3400
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2760
Mailing Address - Country:US
Mailing Address - Phone:855-864-4322
Mailing Address - Fax:866-540-2867
Practice Address - Street 1:9811 W CHARLESTON BLVD STE 2-641
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7528
Practice Address - Country:US
Practice Address - Phone:855-864-4322
Practice Address - Fax:866-540-2867
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250541862084N0400X
CAA1193812084N0400X
HIMD232442084N0600X
MA10149322084N0600X
SC897412084N0600X
NMTM-2023-03122084N0600X
AK2087842084N0600X
FLME1643452084N0600X
NV231492084N0600X
ORMD2166922084N0600X
TXU60752084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235391418Medicaid
CA1235391418Medicaid