MEDICARE: PIYA TREHAN GANDHI D.D.S

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	1223G0001X	General Practice Dentistry	546271768	NY
2	1223G0001X	General Practice Dentistry	26244	TX

General Provider Information

NPI Number	:	1285878553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIYA TREHAN GANDHI D.D.S

Provider Business Mailing Address
First Line	:	2214 BAGBY ST
Second Line	:	APT #4316
City	:	HOUSTON
State	:	TX
Zip	:	77002-8573
Country	:	US
Telephone Number	:	917-453-7207
Fax Number	:

Provider Business Practice Location Address
First Line	:	2214 BAGBY ST
Second Line	:	APT #4316
City	:	HOUSTON
State	:	TX
Zip	:	77002-8573
Country	:	US
Telephone Number	:	917-453-7207
Fax Number	:

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

Provider Enumeration Date	:	04/29/2009
Last Update Date	:	02/02/2011

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