MEDICARE: PRIANKA DESAI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	274947	NY
2	207L00000X	Anesthesiology Physician	S3966	TX

General Provider Information

NPI Number	:	1497076863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRIANKA DESAI M.D.

Provider Business Mailing Address
First Line	:	4646 MUELLER BLVD APT 4034
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 MUELLER BLVD APT 4034
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3423
Country	:	US
Telephone Number	:	832-818-1118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2010
Last Update Date	:	10/04/2021

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Directions to “ PRIANKA DESAI M.D.” Practice Location

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