Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | L0330 | TX |
NPI | 1306847215 |
---|---|
Provider Name | Umang Khetarpal |
First Address | The Woodlands, TX 77384-4192 |
Second Address | The Woodlands, TX 77384-4192 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 17/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040015446 | MEDICARE PIN (RAILROAD) (01) | TX |
044807801 | (05) | TX |
8A1410 | BLUE CROSS BLUE SHIELD (01) | TX |
G80876 | (02) | TX |