Individual
DR. SASHIDHAR V. GANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11851 JOLLYVILLE RD STE 4, AUSTIN, TX 78759-2350
(512) 952-0341
Mailing address
PO BOX 200185, AUSTIN, TX 78720-0185
(512) 244-6452
(512) 244-6582
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M2325
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178758201
—
TX
05
—
178759001
—
TX
Enumeration date
02/03/2006
Last updated
05/10/2023
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