MEDICARE: GURDIP BUTTAR M D-P A

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	104100000X	Social Worker
3	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1235422346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GURDIP BUTTAR M D-P A

Provider Business Mailing Address
First Line	:	12718 TIMBERLAND TRCE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-3343
Country	:	US
Telephone Number	:	832-868-7100
Fax Number	:	713-272-9204

Provider Business Practice Location Address
First Line	:	6006 BELLAIRE BLVD
Second Line	:	SUITE 230
City	:	HOUSTON
State	:	TX
Zip	:	77081-5404
Country	:	US
Telephone Number	:	832-868-7100
Fax Number	:	713-272-9204

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	GURDIP SINGH BUTTAR
Credential	:	M.D.
Telephone Number	:	832-868-7100

Provider Enumeration Date	:	05/23/2011
Last Update Date	:	10/26/2011

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