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NPI Code Detail

MEDICARE: ANITHA R GOWDA M.D.P.A

MEDICARE: ANITHA R GOWDA M.D.P.A
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
1207R00000XInternal Medicine PhysicianL3668TX

General Provider Information

NPI Number : 1710167986
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANITHA R GOWDA M.D.P.A
Provider Business Mailing Address
First Line : 4710 PLATO PARK DR
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-5372
Country : US
Telephone Number : 832-885-2588
Fax Number : 281-605-4352
Provider Business Practice Location Address
First Line : 4780 SWEETWATER BLVD STE 100
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3163
Country : US
Telephone Number : 832-885-2588
Fax Number : 281-605-4352
Authorized Official
Title or Position : PRESIDENT
Name : DR. ANITHA R GOWDA
Credential : M.D
Telephone Number : 832-885-2588
Provider Enumeration Date : 11/05/2007
Last Update Date : 11/05/2007

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