Individual
BHASKAR GURRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5323 HARRY HINES BOULEVARD, DALLAS, TX 75390-7208
(214) 648-3903
(214) 648-2481
Mailing address
P.O. BOX 845347, DALLAS, TX 75284-5347
(214) 648-3903
(214) 648-2481
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301090411
MI
208000000X
Pediatrics Physician
53886
WI
2080P0206X
Pediatric Gastroenterology Physician
53886
WI
2080P0206X
Pediatric Gastroenterology Physician
Primary
Q3683
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528244597
—
WI
Enumeration date
01/21/2008
Last updated
08/17/2015
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