Healthcare Provider Details

I. General information

NPI: 1972568715
Provider Name (Legal Business Name): SUDHIR K. AGGARWAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 W CONGRESS ST
LAFAYETTE LA
70506-4205
US

IV. Provider business mailing address

PO BOX 669162
DALLAS TX
75266-9162
US

V. Phone/Fax

Practice location:
  • Phone: 337-261-6000
  • Fax: 337-261-6003
Mailing address:
  • Phone: 800-343-0269
  • Fax: 504-842-4845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number305198
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: