Provider Demographics
NPI:1861696825
Name:GANDHI, NEELAY RAMESH (MD)
Entity type:Individual
Prefix:
First Name:NEELAY
Middle Name:RAMESH
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 VICTORY GROUP WAY STE 330
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0310
Mailing Address - Country:US
Mailing Address - Phone:972-993-5070
Mailing Address - Fax:972-993-5071
Practice Address - Street 1:3535 VICTORY GROUP WAY STE 330
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-0310
Practice Address - Country:US
Practice Address - Phone:972-993-5070
Practice Address - Fax:972-993-5071
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10028449390200000X
TXN7260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CN317OtherBCBSTX
TXTXB113101Medicare PIN