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General NPI Number Information
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NPI Number | 1750578779
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Entity Type | Individual
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Provider Name | USHA GUJJA M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 03/20/2014
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Provider Practice Location Address
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Address Line | 1401 MEDICAL PKWY BLDG B #220
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City | CEDAR PARK
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State | TX
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Zip | 78613-7464
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Country | US
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Telephone | 512-324-4083
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Fax | 512-324-4717
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Provider Business Mailing Address
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Address Line | PO BOX 26726
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City | AUSTIN
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State | TX
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Zip | 78755-0726
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Country | US
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Telephone | 512-407-8686
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Fax | 512-406-6216
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35089386
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M8690
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License Number State | TX
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