Provider Demographics
NPI:1851349690
Name:GANDHI, KANTI C (MD)
Entity Type:Individual
Prefix:DR
First Name:KANTI
Middle Name:C
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4375 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8359
Mailing Address - Country:US
Mailing Address - Phone:817-595-0707
Mailing Address - Fax:817-595-2633
Practice Address - Street 1:4375 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 215
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8359
Practice Address - Country:US
Practice Address - Phone:817-595-0707
Practice Address - Fax:817-595-2633
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8867207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128184204Medicaid
TX00NP27Medicare PIN
TXC15868Medicare UPIN