Provider Demographics
NPI:1487646048
Name:GOPALAKRISHNAN, DEEPIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPIKA
Middle Name:
Last Name:GOPALAKRISHNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEEPIKA
Other - Middle Name:
Other - Last Name:GOPAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4716 ALLIANCE BLVD., SUITE 340
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:469-800-6100
Mailing Address - Fax:469-800-6109
Practice Address - Street 1:4716 ALLIANCE BLVD., SUITE 340
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:469-800-6100
Practice Address - Fax:469-800-6109
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2285207R00000X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150954904Medicaid
TX150954905Medicaid
TXTXB113019Medicare PIN
TXP00927071Medicare PIN
H54223Medicare UPIN
TX150954905Medicaid