Provider Demographics
NPI:1497224802
Name:GUPTA, BINITA (OD)
Entity Type:Individual
Prefix:DR
First Name:BINITA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:BINITA
Other - Middle Name:BHADRESHKUMAR
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2443 FM 1488 RD APT 1307
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4936
Mailing Address - Country:US
Mailing Address - Phone:832-336-1054
Mailing Address - Fax:
Practice Address - Street 1:2443 FM 1488 RD APT 1307
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4936
Practice Address - Country:US
Practice Address - Phone:832-336-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9608T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty