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Organization
SHYLESH GANTA ,MD , PA
Active
Organization
SHYLESH GANTA ,MD , PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHYLESH GANTA MD (DIRECTOR)
(432) 770-8286
Entity
Organization
Contact information
Practice address
3401 GREENBRIAR STE 100, MIDLAND, TX 79707-4607
(432) 683-6558
(432) 682-5104
Mailing address
PO BOX 4083, MIDLAND, TX 79704-4083
(432) 683-6558
(432) 682-5104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K9066
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192864001
—
TX
Enumeration date
10/24/2007
Last updated
07/01/2010
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