Individual
NAVAKANTH GORREPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 890, FORT WORTH, TX 76104-2145
(817) 250-7230
Mailing address
1325 PENNSYLVANIA AVE STE 890, FORT WORTH, TX 76104-2145
(817) 250-7230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301085993
MI
207R00000X
Internal Medicine Physician
P1314
TX
207RG0100X
Gastroenterology Physician
2011006593
MO
207RG0100X
Gastroenterology Physician
Primary
P1314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330603701
—
TX
01
—
8EE671
BCBS
TX
01
—
P01447513
RAILROAD MEDICARE
TX
Enumeration date
05/11/2007
Last updated
11/17/2021
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