Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2001010856 | MO |
N | 111NI0900X | Internist | 2001010856 | MO |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | N0729 | TX |
NPI | 1063458230 |
---|---|
Provider Name | Jasbir Dhawan |
First Address | Frisco, TX 75035 |
Second Address | Frisco, TX 75035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 05/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100053530A | (05) | OK |
100413460B | (05) | KS |
143561 | ANTHEM (01) | MO |
2087666303 | (05) | MO |
H36261 | (02) | |
P00116533 | RR MEDICARE (01) |