Provider Demographics
NPI:1912142985
Name:GADDAM, SAINATH (MBBS, MD)
Entity type:Individual
Prefix:DR
First Name:SAINATH
Middle Name:
Last Name:GADDAM
Suffix:
Gender:M
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14111 KING RD STE 320
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-0810
Mailing Address - Country:US
Mailing Address - Phone:469-888-4890
Mailing Address - Fax:949-404-6871
Practice Address - Street 1:14111 KING RD STE 320
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-0810
Practice Address - Country:US
Practice Address - Phone:469-888-4890
Practice Address - Fax:949-404-6871
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445400207R00000X
TXR4698207R00000X, 207RI0011X, 207RI0011X
VA0101251759207RC0000X
KYTP714207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease