Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | M8066 | TX |
NPI | 1003077892 |
---|---|
Provider Name | Rupali Rajan Kadakia |
First Address | Pearland, TX 77584-7716 |
Second Address | Pearland, TX 77584-7716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
334862502 | (05) | TX |