Healthcare Provider Details

I. General information

NPI: 1528724689
Provider Name (Legal Business Name): T & G HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25663 SMOTHERMAN RD
FRISCO TX
75033-4756
US

IV. Provider business mailing address

25663 SMOTHERMAN RD
FRISCO TX
75033-4756
US

V. Phone/Fax

Practice location:
  • Phone: 248-613-3673
  • Fax:
Mailing address:
  • Phone: 248-613-3673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHOPANA GANPATH
Title or Position: OWNER
Credential: MD
Phone: 248-613-3673