Venkatesham Guduguntla, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD.09821R Issued in LA

Practice address

1209 East Ninth Street
Bonham, TX 75418

Phone

(903) 583-6617

Fax

(903) 583-6617

NPI assigned

Aug 7, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720097686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 N VILLAGE DR",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754182011",
            "telephone_number": "903-583-8212",
            "fax_number": "903-583-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 EAST NINTH STREET",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "75418",
            "telephone_number": "903-583-6617",
            "fax_number": "903-583-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDUGUNTLA",
        "first_name": "VENKATESHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.09821R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Rachel Griffin, DPT
• Valerie Griffin
• Dona Michelle Griffith, L.P.C.
• Michelle Grigg-Gutierrez, DMD
• Tamerja Dyane Grigg, RRT/RCP
• Stacey Diane Hall, AU.D.
• Benjamin Hanssen, FNP-C
• Melanie Lyn Hardy, FNP-BC
• Misty Gale Hayes, OTR
• Healthline Medical Equipment, Inc.

• Internal Medicine Physician in Bonham, TX
• Providers in Bonham, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.