Healthcare Provider Details

I. General information

NPI: 1124173513
Provider Name (Legal Business Name): NIKHIL AGARWAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1779 E WHITESTONE BLVD BLDG 2
CEDAR PARK TX
78613-6934
US

IV. Provider business mailing address

1779 E WHITESTONE BLVD BLDG 2
CEDAR PARK TX
78613-6934
US

V. Phone/Fax

Practice location:
  • Phone: 512-652-0050
  • Fax: 737-220-7850
Mailing address:
  • Phone: 512-652-0050
  • Fax: 737-220-5785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number40637
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN9669
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP20421
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: