Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 271600 | MA |
N | 207RH0003X | Hematology & Oncology | L7567 | TX |
Y | 207RX0202X | Medical Oncology | 271600 | MA |
NPI | 1083655716 |
---|---|
Provider Name | Dr. Guru P Sonpavde |
First Address | Dallas, TX 75391-1230 |
Second Address | Boston, MA 02215-5418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163866003 | (05) | TX |
163866004 | (05) | TX |
163866005 | (05) | TX |
163866006 | (05) | TX |
163866007 | (05) | TX |
8R1554 | BLUE CROSS OF TEXAS (01) | TX |