Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | H6655 | TX |
NPI | 1063418515 |
---|---|
Provider Name | Darshan Vipin Tolat |
First Address | Conroe, TX 77304-2828 |
Second Address | Conroe, TX 77304-2828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123465002 | (05) | TX |
F53141 | (02) | TX |