Individual
DR. MICKY K GAUTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7808 CLODUS FIELDS DR, DALLAS, TX 75251-2206
(214) 223-9235
(817) 730-9080
Mailing address
PO BOX 561136, THE COLONY, TX 75056-6136
(214) 223-9235
(817) 730-9080
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L1861
TX
Other
Enumeration date
09/25/2006
Last updated
07/11/2025
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