Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | M8276 | TX |
NPI | 1063615136 |
---|---|
Provider Name | Dr. Archana Rao |
First Address | Dallas, TX 75235-2208 |
Second Address | Dallas, TX 75240-5773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 26/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AB2210877-4287 | TRAINEE PERMIT (01) | TX |