Basic Information
Provider Information
NPI: 1245359850
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATRI
FirstName: GOURI
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5080 SPECTRUM DRIVE
Address2: SUITE 1200 WEST TOWER
City: ADDISON
State: TX
PostalCode: 75001
CountryCode: US
TelephoneNumber: 8002323550
FaxNumber:  
Practice Location
Address1: 2010 LEVICK ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191492928
CountryCode: US
TelephoneNumber: 6157784066
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2007
LastUpdateDate: 02/17/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2083X0100XMD031778EPAY Allopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine

No ID Information.


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