Devabrata Ganguly MD PA

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

K7287 Issued in TX

Legal business name

DEVABRATA GANGULY MD PA

Practice address

3144 Clarksville St
Paris, TX 75460-8002

Phone

(903) 784-8700

Fax

(903) 427-0503

NPI assigned

Nov 6, 2012

Organization subpart

No

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

Authorized official

Name

Devabrata Ganguly, MDNPI 1225077274

Title

Owner

Phone

(903) 427-0500

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Devabrata Ganguly, M.D.

  • Internal Medicine Physician
  • Clarksville, TX
  • NPI 1225077274
  Medicare reassignment Authorized official
• Natalie Nicole Cooper, APRN

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1033737424
  Medicare reassignment NPD
• Coy Lane Allen, PA

  • Physician Assistant
  • Paris, TX
  • NPI 1346992401
  Medicare reassignment
• Koren Allen, FNP-BC

  • Family Nurse Practitioner
  • Paris, TX
  • NPI 1841774148
  NPD (past)
• Michelle Lynn Herman, MSN, FNP-C

  • Family Nurse Practitioner
  • Paris, TX
  • NPI 1629403373
  NPD (past)

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1891049342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3144 CLARKSVILLE ST",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754608002",
            "telephone_number": "903-784-8700",
            "fax_number": "903-427-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 CLARKSVILLE ST",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754608002",
            "telephone_number": "903-784-8700",
            "fax_number": "903-427-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVABRATA GANGULY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "GANGULY",
        "authorized_official_first_name": "DEVABRATA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-427-0500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K7287",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "K7287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "412743",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044968802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delta Home Health Care of Paris, Inc
• Brandon Deltoro, DDS
• Lindsay Dennington, LCSW
• Dermatology Clinic, PA
• Joe Lee Deupree, D.O.
• Diabetrx Care
• Diakhomba Diaby, NP-C
• Diamondback Pain PA
• William Daryl Dickey, MD
• Digestive Disease Center

• Geriatric Medicine (Internal Medicine) Physician in Paris, TX
• Providers in Paris, TX by specialty
• Geriatric Medicine (Internal Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.