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Individual
SUPRIYA GUPTA
Active
Individual
SUPRIYA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-143790
IL
207Q00000X
Family Medicine Physician
Primary
S3527
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-143790
STATE LICENSE
IL
05
—
415262101
—
TX
05
—
415262102
—
TX
05
—
415262103
—
TX
Enumeration date
08/08/2014
Last updated
06/08/2021
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