Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 55729 | CT |
N | 207RR0500X | Rheumatology | S6778 | TX |
NPI | 1033422662 |
---|---|
Provider Name | Sampada Acharya |
First Address | Fort Worth, TX 76104-4141 |
Second Address | Fort Worth, TX 76104-4141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2010 |
Last Update Date | 15/01/2021 |