Provider Demographics
NPI:1801859491
Name:SETHI, GURDEEP S (MD)
Entity Type:Individual
Prefix:
First Name:GURDEEP
Middle Name:S
Last Name:SETHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:920 MEDICAL PLAZA DR
Mailing Address - Street 2:#140
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:281-364-8887
Mailing Address - Fax:281-364-9313
Practice Address - Street 1:920 MEDICAL PLAZA DR
Practice Address - Street 2:#140
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-364-8887
Practice Address - Fax:281-364-9313
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK6310207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX44896101Medicaid
TX8642J0Medicare ID - Type Unspecified
TX44896101Medicaid
TX830008303Medicare PIN