Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | R3572 | TX |
Y | 208600000X | Surgeon | R3572 | TX |
N | 2086S0120X | Pediatric Surgery | 062071 | GA |
N | 2086S0120X | Pediatric Surgery | 60-262191 | NY |
N | 2086S0120X | Pediatric Surgery | R3572 | TX |
NPI | 1255575122 |
---|---|
Provider Name | Dr. Samir Pandya |
First Address | Dallas, TX 75235-7701 |
Second Address | Dallas, TX 75235-7701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2009 |
Last Update Date | 10/11/2021 |