Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 31138 | TX |
NPI | 1073997854 |
---|---|
Provider Name | Ankur Dahiya |
First Address | Austin, TX 78750-1934 |
Second Address | Austin, TX 78750-1934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2015 |
Last Update Date | 12/07/2015 |