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General NPI Number Information
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NPI Number | 1144621012
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Entity Type | Individual
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Provider Name | DEEPTHI GANDHIRAJ M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 11/30/2025
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Provider Practice Location Address
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Address Line | 2851 S AVENUE B BLDG 20
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City | YUMA
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State | AZ
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Zip | 85364-7726
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Country | US
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Telephone | 928-336-2434
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 PRESTON ROAD, STE 300 PMB 1403
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 281-468-9920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 77123
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 036177865
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | T4365
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | T4365
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 036177865
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 77123
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License Number State | AZ
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