Provider Demographics
NPI:1942492228
Name:GORTHI, JANARDHANA RAO (MBBS)
Entity Type:Individual
Prefix:DR
First Name:JANARDHANA
Middle Name:RAO
Last Name:GORTHI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 1901
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2719
Mailing Address - Country:US
Mailing Address - Phone:713-441-2762
Mailing Address - Fax:713-790-6334
Practice Address - Street 1:6550 FANNIN ST STE 1901
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2719
Practice Address - Country:US
Practice Address - Phone:713-441-2762
Practice Address - Fax:713-790-6334
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31238207RC0000X
TXT3782207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1942492228Medicaid
IA1942492228Medicaid