Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | L9614 | TX |
NPI | 1255373619 |
---|---|
Provider Name | Dr. Gurpreet S Bajaj |
First Address | Fort Worth, TX 76104 |
Second Address | Fort Worth, TX 76104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 05/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171322401 | (05) | TX |
H85611 | (02) | TX |