Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | Q6733 | TX |
NPI | 1255604104 |
---|---|
Provider Name | Utpal S Bhalala |
First Address | San Antonio, TX 78207 |
Second Address | San Antonio, TX 78207-3154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2012 |
Last Update Date | 20/01/2016 |