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Individual
DR. PREM P GUPTA
Active
Individual
DR. PREM P GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
F7772
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101054
SUPERIOR HEALTHPLAN
TX
01
—
114191103
FIRSTCARE HMO
TX
05
—
133070608
—
TX
05
—
155931202
—
TX
01
—
4403201
AETNA ID
TX
01
—
8H3960
BCBS TX
TX
Enumeration date
07/07/2006
Last updated
05/30/2012
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