Provider Demographics
NPI:1972706323
Name:VISWAM, GITA (MD)
Entity Type:Individual
Prefix:
First Name:GITA
Middle Name:
Last Name:VISWAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GITA
Other - Middle Name:
Other - Last Name:SETTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1407 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6301
Mailing Address - Country:US
Mailing Address - Phone:972-801-9689
Mailing Address - Fax:
Practice Address - Street 1:1407 14TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6301
Practice Address - Country:US
Practice Address - Phone:972-801-9689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1943208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics