Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | H2230 | TX |
NPI | 1023024478 |
---|---|
Provider Name | Amit K Bansal |
First Address | Pasadena, TX 77504 |
Second Address | Pasadena, TX 77504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138535310 | (05) | TX |
C13134 | (02) |