Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | MD062334L | PA |
Y | 207RX0202X | Medical Oncology | L7896 | TX |
NPI | 1174546915 |
---|---|
Provider Name | Dr. Rudranath Talukdar |
First Address | Dallas, TX 75284-4658 |
Second Address | Waco, TX 76712-8897 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 05/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163612802 | (05) | TX |
5388644 | AETNA (01) | TX |
8W0432 | BCBSTX (01) | TX |
G48845 | (02) | TX |