Organization
GUPTA AND GUPTA PEDIATRICS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PREM P GUPTA M.D. (PRESIDENT)
(432) 685-5029
Entity
Organization
Contact information
Practice address
302 SECOR ST, MIDLAND, TX 79701-6343
(432) 685-5029
(432) 685-3968
Mailing address
302 SECOR ST, MIDLAND, TX 79701-6343
(432) 685-5029
(432) 685-3968
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0095JQ
BCBS TX
TX
Enumeration date
07/03/2006
Last updated
08/22/2020
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