Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | M1427 | TX |
NPI | 1073535076 |
---|---|
Provider Name | Dr. Vijay K Gunuganti |
First Address | Dallas, TX 75391-1230 |
Second Address | San Antonio, TX 78258-4791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 28/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1121552 | AETNA HMO (01) | TX |
174969901 | (05) | TX |
174969902 | (05) | TX |
7326655 | AETNA PPO (01) | TX |
8S2181 | BLUECROSS/BLUESHIELD TX. (01) | TX |
I15374 | (02) | TX |
P00250234 | RAILROAD MEDICARE (01) | TX |
P01547608 | RAILROAD MEDICARE (01) | TX |