Provider Demographics
NPI:1497071203
Name:PATANKAR, GAUTAM RANJAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GAUTAM
Middle Name:RANJAN
Last Name:PATANKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13325 HARGRAVE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4541
Mailing Address - Country:US
Mailing Address - Phone:281-955-7863
Mailing Address - Fax:281-469-8196
Practice Address - Street 1:13325 HARGRAVE RD STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4541
Practice Address - Country:US
Practice Address - Phone:281-955-7863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4797207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease