Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | E-6068 | AR |
N | 207N00000X | Dermatologist | N7906 | TX |
N | 207ND0101X | MOHS-Micrographic Surgeon | E-6068 | AR |
Y | 207ND0101X | MOHS-Micrographic Surgeon | N7906 | TX |
N | 207NS0135X | Procedural Dermatology | E-6068 | AR |
N | 207NS0135X | Procedural Dermatology | N7906 | TX |
NPI | 1275702656 |
---|---|
Provider Name | Sanjay Bhambri |
First Address | Rockwall, TX 75032-7809 |
Second Address | Rockwall, TX 75032-7809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2008 |
Last Update Date | 27/09/2011 |