Provider Demographics
NPI:1952626434
Name:GUPTA, NANDITA (MD)
Entity Type:Individual
Prefix:DR
First Name:NANDITA
Middle Name:
Last Name:GUPTA
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 1:1919 NORTH LOOP W
Mailing Address - Street 2:SUITE 395
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1374
Mailing Address - Country:US
Mailing Address - Phone:713-861-9500
Mailing Address - Fax:713-861-9501
Practice Address - Street 1:1919 NORTH LOOP W
Practice Address - Street 2:SUITE 395
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1374
Practice Address - Country:US
Practice Address - Phone:713-861-9500
Practice Address - Fax:713-861-9501
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB115313Medicare PIN
TXTXB115314Medicare PIN