Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | E1933 | TX |
NPI | 1013098706 |
---|---|
Provider Name | Indrani Dorai Swami |
First Address | Victoria, TX 77904-2178 |
Second Address | Victoria, TX 77904-2155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 15/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105651701 | (05) | TX |
105651702 | (05) | TX |
742710179A006 | CHAMPUS (01) | TX |
87W117 | BLUE CROSS (01) | TX |
MDE1933 | WORKERS COMPENSATION (01) | TX |