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NPI Code Detail

MEDICARE: DR. ABHILASHA GUPTA MD

MEDICARE: DR. ABHILASHA GUPTA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianL5355TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2TXB150644OTHERTXWELLMED PTAN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225032931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABHILASHA GUPTA MD
Provider Business Mailing Address
First Line : 13376 RESEARCH BLVD
Second Line : STE 110
City : AUSTIN
State : TX
Zip : 78750-3237
Country : US
Telephone Number : 512-219-0129
Fax Number : 512-219-0393
Provider Business Practice Location Address
First Line : 2700 W PECAN ST STE 102
Second Line :
City : PFLUGERVILLE
State : TX
Zip : 78660-3069
Country : US
Telephone Number : 512-421-3750
Fax Number : 512-421-3751
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 12/27/2017

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Directions to “ DR. ABHILASHA GUPTA MD” Practice Location

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