Individual
AMEET VENKAT THATISHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6200 W PARKER RD, PLANO, TX 75093-8185
(972) 981-3225
(972) 981-3967
Mailing address
6200 W PARKER RD, PLANO, TX 75093-8185
(972) 981-3225
(972) 981-3967
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
061524
GA
207R00000X
Internal Medicine Physician
Primary
R5944
TX
208M00000X
Hospitalist Physician
061524
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01343899
AMERIGROUP
—
05
—
398928354A
—
GA
05
—
398928354B
—
GA
01
—
473627
WELLCARE
GA
05
—
G61524
—
SC
01
—
P00635639
RR MEDICARE
GA
01
—
P00803285
RR MEDICARE
—
Enumeration date
09/13/2007
Last updated
04/21/2020
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