Individual
GITA VISWAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1407 14TH ST, PLANO, TX 75074-6301
(972) 801-9689
Mailing address
1407 14TH ST, PLANO, TX 75074-6301
(972) 801-9689
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N1943
TX
Other
Enumeration date
06/05/2007
Last updated
03/30/2009
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