Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | M6548 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | M6548 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD2020-0302 | NM |
NPI | 1144243890 |
---|---|
Provider Name | Dr. Nitin Budhwar |
First Address | Dallas, TX 75235-6411 |
Second Address | Dallas, TX 75235-6411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 12/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H80246 | (02) | NC |