Doctor Name: | DR. SANDEEP GUTTIKONDA |
NPI Number: | 1003040031 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 5323 Harry Hines Boulevard Dallas, TX - 753907208 |
Business Phone Number: | 2146483916 |
Business Fax Number: | 2146488423 |
Mailing Address: | P.o. Box 845347, DALLAS |
State: | TX |
Postal Code: | 752845347 |
Phone Number: | 2146483916 |
Fax Number: | 2146488423 |
NPI Enumeration Date: | 05/05/2009 |
NPI Last Update Date: | 09/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |