Healthcare Provider Details

I. General information

NPI: 1427779131
Provider Name (Legal Business Name): GREATER DALLAS ARYA SAMAJ CANCER CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 E ARAPAHO RD STE 205
RICHARDSON TX
75081-2269
US

IV. Provider business mailing address

PO BOX 514
ALLEN TX
75013-0010
US

V. Phone/Fax

Practice location:
  • Phone: 972-635-3680
  • Fax: 313-731-3680
Mailing address:
  • Phone: 214-733-0363
  • Fax: 313-731-3680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. VIJAY BHALLA
Title or Position: DIRECTOR
Credential:
Phone: 214-733-0363