MEDICARE: DR. INDRANIL SEN-GUPTA M.D.

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
1	2084N0400X	Neurology Physician	A119381	CA
2	2084N0400X	Neurology Physician	125054186	IL
3	2084N0600X	Clinical Neurophysiology Physician	23149	NV
4	2084N0600X	Clinical Neurophysiology Physician	TM-2023-0312	NM
5	2084N0600X	Clinical Neurophysiology Physician	208784	AK
6	2084N0600X	Clinical Neurophysiology Physician	MD216692	OR
7	2084N0600X	Clinical Neurophysiology Physician	ME164345	FL
8	2084N0600X	Clinical Neurophysiology Physician	MD23244	HI
9	2084N0600X	Clinical Neurophysiology Physician	1014932	MA
10	2084N0600X	Clinical Neurophysiology Physician	89741	SC
11	2084N0600X	Clinical Neurophysiology Physician	U6075	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1235391418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INDRANIL SEN-GUPTA M.D.

Provider Business Mailing Address
First Line	:	4500 ELDORADO PKWY STE 3400
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2760
Country	:	US
Telephone Number	:	855-864-4322
Fax Number	:	866-540-2867

Provider Business Practice Location Address
First Line	:	9811 W CHARLESTON BLVD STE 2-641
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	855-864-4322
Fax Number	:	866-540-2867

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2008
Last Update Date	:	05/01/2024

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Directions to “ DR. INDRANIL SEN-GUPTA M.D.” Practice Location

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