Provider Demographics
NPI:1710148622
Name:GIDWANI, GIRISH
Entity Type:Individual
Prefix:DR
First Name:GIRISH
Middle Name:
Last Name:GIDWANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8305 KNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3905
Mailing Address - Country:US
Mailing Address - Phone:713-795-1106
Mailing Address - Fax:713-383-4470
Practice Address - Street 1:8305 KNIGHT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3905
Practice Address - Country:US
Practice Address - Phone:713-795-1106
Practice Address - Fax:713-383-4470
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125054679207R00000X
TXP95752085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine