Provider Demographics
NPI:1235445735
Name:ARDHANARI, GNANA DHEEPA (MD)
Entity Type:Individual
Prefix:DR
First Name:GNANA
Middle Name:DHEEPA
Last Name:ARDHANARI
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 1:6400 FANNIN ST STE 2350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1554
Mailing Address - Country:US
Mailing Address - Phone:713-486-6740
Mailing Address - Fax:
Practice Address - Street 1:6400 FANNIN ST STE 2350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1554
Practice Address - Country:US
Practice Address - Phone:713-486-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1165208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX380330602OtherCSHCN
TX380330601Medicaid