Individual
GAITHRI ARUNESH VIVEKANANTHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
6124 W PARKER RD, SUITE 530, PLANO, TX 75093-8122
(214) 778-1075
(214) 778-1237
Mailing address
6124 W PARKER RD, SUITE 530, PLANO, TX 75093-8122
(214) 778-1075
(214) 778-1237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07676
TX
363AM0700X
Medical Physician Assistant
PA07076
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283184401
—
TX
05
—
283184402
—
TX
05
—
283184403
—
TX
01
—
PA07076
PA LICENSE
TX
Enumeration date
09/23/2010
Last updated
02/08/2012
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