Organization
CENTER FOR VEIN RESTORATION TX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADITYA GUPTA MD (MANAGER)
(855) 830-8346
Entity
Organization
Contact information
Practice address
7900 FARM TO MARKET ROAD 1826, BUILDING 1 SUITE 170, AUSTIN, TX 78735-8977
(855) 830-8346
Mailing address
7474 GREENWAY CENTER DR STE 1000, GREENBELT, MD 20770-3500
(855) 830-8346
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0589292
—
NJ
Enumeration date
12/27/2018
Last updated
04/30/2024
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