Provider Demographics
NPI:1770743577
Name:GOVINDA, NAMITHA C (MD)
Entity type:Individual
Prefix:
First Name:NAMITHA
Middle Name:C
Last Name:GOVINDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E CAMPBELL RD STE 400
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6797
Mailing Address - Country:US
Mailing Address - Phone:214-377-3700
Mailing Address - Fax:
Practice Address - Street 1:8200 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4426
Practice Address - Country:US
Practice Address - Phone:214-221-6362
Practice Address - Fax:214-345-8784
Is Sole Proprietor?:No
Enumeration Date:2008-06-15
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4114207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196075901Medicaid
TX8L0826Medicare PIN