Provider Demographics
NPI:1447825815
Name:GOOTY, NAGA (MD)
Entity type:Individual
Prefix:
First Name:NAGA
Middle Name:
Last Name:GOOTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14111 KING RD STE 320
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-0810
Mailing Address - Country:US
Mailing Address - Phone:718-879-0325
Mailing Address - Fax:
Practice Address - Street 1:14111 KING RD STE 320
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-0810
Practice Address - Country:US
Practice Address - Phone:718-879-0325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10075208390200000X
TXV3600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program