Provider Demographics
NPI:1760467351
Name:GUPTA, SWATI K (MD)
Entity Type:Individual
Prefix:DR
First Name:SWATI
Middle Name:K
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5934 GARDEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3143
Mailing Address - Country:US
Mailing Address - Phone:713-623-6555
Mailing Address - Fax:713-623-6569
Practice Address - Street 1:7710 BEECHNUT ST
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3100
Practice Address - Country:US
Practice Address - Phone:713-623-6555
Practice Address - Fax:713-623-6569
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3323207RC0000X, 207UN0901X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150503402Medicaid
TX8A3586Medicare ID - Type UnspecifiedMEDICARE
TX150503402Medicaid