Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 27615 | TX |
Y | 213EG0000X | General Practice | 27615 | TX |
N | 1223G0001X | General Practice | DN1855158 | MA |
N | 213EG0000X | General Practice | DN1855158 | MA |
NPI | 1003044025 |
---|---|
Provider Name | Dr. Radhika Iyer |
First Address | Irving, TX 75062-5348 |
Second Address | Irving, TX 75062-5348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 19/02/2021 |