Provider Demographics
NPI:1487040341
Name:GURUNG, SIDHANTA (MD)
Entity Type:Individual
Prefix:
First Name:SIDHANTA
Middle Name:
Last Name:GURUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1110 N SARAH DEWITT DR
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:TX
Mailing Address - Zip Code:78629-3311
Mailing Address - Country:US
Mailing Address - Phone:830-672-3845
Mailing Address - Fax:830-672-4746
Practice Address - Street 1:1348 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5126
Practice Address - Country:US
Practice Address - Phone:830-433-4648
Practice Address - Fax:830-433-4670
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT7577207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology