Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10034497 | TX |
N | 111NI0900X | Internist | BP10034497 | TX |
Y | 207RH0003X | Hematology & Oncology | P7801 | TX |
NPI | 1023343357 |
---|---|
Provider Name | Premal Dilip Lulla |
First Address | Houston, TX 77030-3411 |
Second Address | Houston, TX 77030-3411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2009 |
Last Update Date | 12/04/2017 |