Provider Demographics
NPI:1982479317
Name:DURGA GSP, PLLC
Entity Type:Organization
Organization Name:DURGA GSP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRERNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-463-8603
Mailing Address - Street 1:16103 W LITTLE YORK RD STE O
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6867
Mailing Address - Country:US
Mailing Address - Phone:281-463-8603
Mailing Address - Fax:281-858-0471
Practice Address - Street 1:16103 W LITTLE YORK RD STE O
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6867
Practice Address - Country:US
Practice Address - Phone:281-463-8603
Practice Address - Fax:281-858-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty