Provider Demographics
NPI:1194080440
Name:RAKESH GUPTA MD OBSTETRICS AND GYNECOLOGY, PA
Entity type:Organization
Organization Name:RAKESH GUPTA MD OBSTETRICS AND GYNECOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:NIZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-235-5895
Mailing Address - Street 1:13215 GLAD ACRES
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234
Mailing Address - Country:US
Mailing Address - Phone:301-591-4184
Mailing Address - Fax:972-559-3634
Practice Address - Street 1:13215 GLAD ACRES
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234
Practice Address - Country:US
Practice Address - Phone:301-591-4184
Practice Address - Fax:972-559-3634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty