Provider Demographics
NPI:1174138663
Name:GYAWALI-SEDAI, GITA
Entity type:Individual
Prefix:
First Name:GITA
Middle Name:
Last Name:GYAWALI-SEDAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 SUNBURST CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7440
Mailing Address - Country:US
Mailing Address - Phone:775-971-7796
Mailing Address - Fax:
Practice Address - Street 1:1724 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3604
Practice Address - Country:US
Practice Address - Phone:713-597-5131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145986207R00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine