Healthcare Provider Details

I. General information

NPI: 1700082146
Provider Name (Legal Business Name): GAYATRI V NAIR M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7428 WHISTLESTOP DR
AUSTIN TX
78749-3303
US

IV. Provider business mailing address

7428 WHISTLESTOP DR
AUSTIN TX
78749-3303
US

V. Phone/Fax

Practice location:
  • Phone: 917-349-4051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA08614800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number54461-20
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberBP10047148
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberQ3743
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: