Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | Q4574 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | Q4574 | TX |
NPI | 1174767495 |
---|---|
Provider Name | Dr. Kunj K Desai |
First Address | Jersey City, NJ 07305-5504 |
Second Address | San Antonio, TX 78240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2009 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
095077350 | (05) | TX |
363442002 | (05) | TX |