Provider Demographics
NPI:1740620384
Name:GALI, VASANTHA LAKSHMI (MD)
Entity type:Individual
Prefix:DR
First Name:VASANTHA
Middle Name:LAKSHMI
Last Name:GALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VASANTHA
Other - Middle Name:LAKSHMI
Other - Last Name:ALAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17200 ST LUKES WAY
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8007
Mailing Address - Country:US
Mailing Address - Phone:936-266-3376
Mailing Address - Fax:
Practice Address - Street 1:17200 ST LUKES WAY
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-8007
Practice Address - Country:US
Practice Address - Phone:936-266-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR8566207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program