Individual
DEEPA GANESHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12398 FM 423 STE 600, FRISCO, TX 75033-0158
(214) 494-4622
Mailing address
12398 FM 423 STE 600, FRISCO, TX 75033-0158
(214) 494-4622
(214) 494-4609
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
017942
ME
208000000X
Pediatrics Physician
2002-0360
NM
208000000X
Pediatrics Physician
Primary
R3514
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201041812
—
NM
05
—
406890001
—
TX
05
—
433096999
—
ME
Enumeration date
07/10/2008
Last updated
06/27/2022
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