MEDICARE: GUPTA, D.O. & ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	261QU0200X	Urgent Care Clinic/Center	J2044	TX

General Provider Information

NPI Number	:	1093815078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUPTA, D.O. & ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	821 E INTERSTATE 20
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-6745
Country	:	US
Telephone Number	:	817-596-4313
Fax Number	:	817-341-2394

Provider Business Practice Location Address
First Line	:	821 E INTERSTATE 20
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-6745
Country	:	US
Telephone Number	:	817-596-4313
Fax Number	:	817-341-2394

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AMIT GUPTA
Credential	:	MHA
Telephone Number	:	469-348-8343

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	12/19/2025

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