Individual provider Active NPI

Vasantha Lakshmi Gali, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Conroe, TX
National Provider Identifier
1740620384
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
R8566 Issued in TX
Practice address
17200 St Lukes Way
Conroe, TX 77384-8007
Phone
(936) 266-3376
NPI assigned
Jun 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R8566 TX Primary

Addresses

Primary practice location

17200 St Lukes Way
Conroe, TX 77384-8007

Mailing address

17200 St Lukes Way
Conroe, TX 77384-8007
Phone (936) 266-3376

Other practice location 1

1400 W 22nd St
Sioux Falls, SD 57105-1554
Phone (605) 357-1386

Other names 1

  • Dr. Vasantha Lakshmi Alam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922000263 TX Practitioner - Pathology 7618106998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8527956176, 47 clinicians

Practice addresses (Care Compare)

100 Medical Dr
Lake Jackson, TX 77566-5674
Phone (979) 297-4411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8566TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2020 Accepting new patients
Baylor College of Medicine Anatomic Pathology & Clinical Pathology Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

1115 Avenue G
Bay City, TX 77414
Phone (979) 245-6383

1 Baylor Plz
Rm 286A
Houston, TX 77030
Phone (713) 873-3930

110 Memorial Hospital Dr
Huntsville, TX 77340
Phone (936) 291-4276

481 Ih 45 S
Ste 7
Huntsville, TX 77340
Phone (409) 291-9704

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

17200 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-2008

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1740620384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 ST LUKES WAY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773848007",
            "telephone_number": "936-266-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 ST LUKES WAY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773848007",
            "telephone_number": "936-266-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051554",
            "country_code": "US",
            "telephone_number": "605-357-1386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALI",
        "first_name": "VASANTHA",
        "middle_name": "LAKSHMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "R8566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VASANTHA",
            "last_name": "ALAM",
            "middle_name": "LAKSHMI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.