Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | ME121991 | FL |
N | 208000000X | Pediatrician | ME121991 | FL |
Y | 208000000X | Pediatrician | P2199 | TX |
N | 2080P0207X | Pediatric Hematology-Oncologist | P2199 | TX |
NPI | 1235332032 |
---|---|
Provider Name | Dr. Sunil Udebhan Bochare |
First Address | Dallas, TX 75373-4812 |
Second Address | San Antonio, TX 78207-0903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 29/01/2021 |