Healthcare Provider Details

I. General information

NPI: 1073731683
Provider Name (Legal Business Name): MADHURI GUDIPATY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5953 DALLAS PKWY STE 200A
PLANO TX
75093-8189
US

IV. Provider business mailing address

5953 DALLAS PKWY STE 200A
PLANO TX
75093-8189
US

V. Phone/Fax

Practice location:
  • Phone: 972-867-7500
  • Fax: 972-578-7550
Mailing address:
  • Phone: 972-867-7500
  • Fax: 972-578-7550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberN5087
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: