Healthcare Provider Details

I. General information

NPI: 1245494657
Provider Name (Legal Business Name): TANYA VARMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 REGENT BLVD
IRVING TX
75063-2445
US

IV. Provider business mailing address

14275 MIDWAY RD STE 400
ADDISON TX
75001-3676
US

V. Phone/Fax

Practice location:
  • Phone: 972-934-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax: 610-271-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberP7591
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License NumberGETP
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: