Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | P0805 | TX |
Y | 207KA0200X | Allergist | P0805 | TX |
N | 207RA0201X | Internist - Allergy & Immunology | P0805 | TX |
NPI | 1457575615 |
---|---|
Provider Name | Swapnil Vaidya |
First Address | Fort Worth, TX 76244-6306 |
Second Address | Fort Worth, TX 76244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 13/03/2019 |