Individual
DR. DEVABRATA GANGULY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W MAIN ST, CLARKSVILLE, TX 75426-3523
(903) 427-0500
(903) 427-0503
Mailing address
3144 CLARKSVILLE ST, PARIS, TX 75460-8002
(903) 784-8700
(903) 784-7502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K7287
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
K7287
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0096JE
BCBS
TX
05
—
044968802
—
TX
01
—
110247089
RAIL ROAD MEDICARE
TX
Enumeration date
06/05/2006
Last updated
09/28/2015
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