Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | M3511 | TX |
N | 207RP1001X | Pulmonary Disease | M3511 | TX |
N | 207RS0012X | Sleep Medicine | M3511 | TX |
NPI | 1316983364 |
---|---|
Provider Name | Dr. Nilesh B Dave |
First Address | Dallas, TX 75244-7711 |
Second Address | Dallas, TX 75251-2235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 29/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I17762 | (02) | TX |