# DR. AJAY K GUPTA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629026067
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | J8562 | TX | Yes |

## Other

- **Enumeration date:** 05/05/2006
- **Last updated:** 05/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 124005307 | — | TX |
| 05 | — | 124005308 | — | TX |
| 01 | — | 82T248 | BCBSTX PROVIDER NUMB | TX |