Healthcare Provider Details

I. General information

NPI: 1144340316
Provider Name (Legal Business Name): AMARNATH LAXMINARAYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARKLAND HOPSPITAL, HARRY HINES BLVD 5201, JAIL HEALTH
DALLAS TX
75235
US

IV. Provider business mailing address

724 W MAIN ST SUITE 160
LEWISVILLE TX
75067-3514
US

V. Phone/Fax

Practice location:
  • Phone: 214-962-5702
  • Fax: 214-962-5891
Mailing address:
  • Phone: 972-219-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL0368
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: