Healthcare Provider Details
I. General information
NPI: 1790316701
Provider Name (Legal Business Name): KRUTI DAJEE M.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2020
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2745 VIRGINIA PKWY STE 300
MCKINNEY TX
75071-4915
US
IV. Provider business mailing address
2745 VIRGINIA PKWY STE 300
MCKINNEY TX
75071-4915
US
V. Phone/Fax
- Phone: 469-343-4231
- Fax: 469-466-6120
- Phone: 214-564-6550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KRUTI
P
DAJEE
Title or Position: PRESIDENT
Credential: MD
Phone: 214-564-6550