Provider Demographics
NPI:1437105715
Name:GUPTA, SONIKA (MD)
Entity Type:Individual
Prefix:MS
First Name:SONIKA
Middle Name:
Last Name:GUPTA
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 1:8042 WURZBACH RD STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3806
Mailing Address - Country:US
Mailing Address - Phone:210-963-6100
Mailing Address - Fax:210-461-5060
Practice Address - Street 1:8042 WURZBACH RD STE 230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3806
Practice Address - Country:US
Practice Address - Phone:210-963-6100
Practice Address - Fax:210-461-5060
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6883207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX283736102Medicaid
TX283736102Medicaid
TX283736102Medicaid