Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | M7314 | TX |
NPI | 1073707667 |
---|---|
Provider Name | Polina Kaloyanova |
First Address | Dallas, TX 75230-6834 |
Second Address | Dallas, TX 75230-6834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 19/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
M7314 | TSBME (01) | TX |