1033513205 NPI number — SONIKA GUPTA, M.D., PLLC

Table of content: (NPI 1033513205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033513205 NPI number — SONIKA GUPTA, M.D., PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SONIKA GUPTA, M.D., PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033513205
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8042 WURZBACH RD., STE. 230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-963-6100
Provider Business Mailing Address Fax Number:
210-461-5060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8042 WURZBACH RD STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-3806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-963-6100
Provider Business Practice Location Address Fax Number:
210-461-5060
Provider Enumeration Date:
10/17/2014

Additional Information

Authorized Official

Authorized Official Last Name:
GUPTA
Authorized Official First Name:
SONIKA
Authorized Official Middle Name:
Authorized Official Title or Position:
MD/OWNER
Authorized Official Telephone Number:
210-233-9678

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 344754201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com