Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 04-37759 | KS |
Y | 2080P0203X | Pediatric Critical Care Doctor | P3270 | TX |
NPI | 1215162326 |
---|---|
Provider Name | Priyank Jayeshkumar Yagnik |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2009 |
Last Update Date | 08/02/2022 |