Healthcare Provider Details

I. General information

NPI: 1184814022
Provider Name (Legal Business Name): HARSHA VARDHAN GANGA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BLOSSOM STREET STE 275
WEBSTER TX
77598-4241
US

IV. Provider business mailing address

250 BLOSSOM STREET STE 275
WEBSTER TX
77598-4241
US

V. Phone/Fax

Practice location:
  • Phone: 832-553-6126
  • Fax: 888-905-2440
Mailing address:
  • Phone: 832-553-6126
  • Fax: 888-905-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberU4510
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME152580
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: