Provider Demographics
NPI:1710910773
Name:KANHERE, GAURI G (MD)
Entity Type:Individual
Prefix:
First Name:GAURI
Middle Name:G
Last Name:KANHERE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 N FM 3167 STE C
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-7009
Mailing Address - Country:US
Mailing Address - Phone:956-352-1344
Mailing Address - Fax:956-352-1343
Practice Address - Street 1:131 N FM 3167 STE C
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-7009
Practice Address - Country:US
Practice Address - Phone:956-352-1344
Practice Address - Fax:956-352-1343
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2961207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453812OtherMEDICARE RURAL CLINIC
TX126933404Medicaid
TXH49368Medicare UPIN
TX453812OtherMEDICARE RURAL CLINIC