Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G6009 | TX |
NPI | 1023057494 |
---|---|
Provider Name | Dr. Rajendra Prasad Sarva |
First Address | Midland, TX 79703-4861 |
Second Address | Midland, TX 79703-4861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131473402/080363701 | (05) | TN |
C21572 | (02) | TX |