1134288483 NPI number — DR. PRABHAKAR GUPTA NARASIMHAIAH GARLA

Table of content: DR. GILLIAN LYNNE GOW-BARBER RPH (NPI 1598352635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134288483 NPI number — DR. PRABHAKAR GUPTA NARASIMHAIAH GARLA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARLA
Provider First Name:
PRABHAKAR GUPTA
Provider Middle Name:
NARASIMHAIAH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARLA
Provider Other First Name:
PRABHAKAR GUPTA
Provider Other Middle Name:
NARASIMHAIAH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1134288483
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
74 DUNDEE LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARRINGTON HILLS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60010-5106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-842-1636
Provider Business Mailing Address Fax Number:
206-666-7345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
74 DUNDEE LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARRINGTON HILLS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60010-5106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-842-1636
Provider Business Practice Location Address Fax Number:
206-666-7345
Provider Enumeration Date:
12/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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