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General NPI Number Information
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NPI Number | 1144570599
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Entity Type | Organization
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Legal Business Name | GUMMADI & DESAI LLC
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 2717 MICHAEL ANGELO STE 302
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City | EDINBURG
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State | TX
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Zip | 78539-1409
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Country | US
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Telephone | 956-668-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 2717 MICHAEL ANGELO STE 302
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City | EDINBURG
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State | TX
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Zip | 78539-1409
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Country | US
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Telephone | 956-668-1111
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | SHANNON L LOPEZ
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Credential |
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Telephone | 956-668-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | NULL
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