Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP0504X | Public Medicine | 2389 | TX |
N | 213EP1101X | Primary Podiatric Medicine | 2389 | TX |
N | 111NR0200X | Radiology | 2389 | TX |
N | 213ER0200X | Radiology | 2389 | TX |
N | 2081S0010X | Sports Medicine | 2389 | TX |
N | 213ES0000X | Sports Medicine | 2389 | TX |
Y | 213ES0103X | Foot & Ankle Surgery | 2389 | TX |
N | 213ES0131X | Foot Surgery | 2389 | TX |
NPI | 1598114480 |
---|---|
Provider Name | Dhvanil Thakor |
First Address | Sugar Land, TX 77496-6218 |
Second Address | Pearland, TX 77584-8508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2016 |
Last Update Date | 20/01/2022 |