NPI age
20 years
Enumerated 2005-11-23
● Active
Type 1 · Individual
DR. Manjushree Gautam, M.D.
Gautam is 1 of 70 internal medicine providers in Fort Worth and 1 of 1807 in Texas.
Primary specialty
Internal Medicine
Plus 2 subspecialties
Licensed in
TX, AZ
2 states
Status
Active
No deactivations on record
Last NPPES update
2015-07-21
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1807 active internal medicine providers in Texas.
NPI age
20 years
≈ at median (19 yr)
State licenses
2 states
Top 83% — 17% of peers are multi-state
Subspecialties
2
In the 35% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-11Enumerated in NPPES
2005
2026
Where they practice
Practice location
1250 8th Ave, Suite 515
Fort Worth, TX 761044124
Mailing address
1250 8th Ave, Suite 515
Fort Worth, TX 761044124
Specialties
-
Internal Medicine PrimaryAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and...
-
Internal MedicineThe discipline of Hepatology encompasses the structure, function, and diseases of the liver and biliary tract. The American Board of Internal Medicine considers Hepatology part of the subspecialty of gastroenterology. Physicians who...
-
Internal MedicineAn internist with special knowledge and the skill required of a gastroenterologist to care for patients prior to and following hepatic transplantation that spans all phases of liver transplantation. Selection of appropriate recipients...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 8BN847 | BCBSTX |
| 05 (TX) | 217199301 | |
| 05 (AZ) | 935554 | |
| 01 (AZ) | 86080015085259D008 | TRIWEST |
| 01 (AZ) | P00278312 | RAILROAD MEDICARE |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 29 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new internal medicine provider has been added in Fort Worth in the last 180 days.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.