Healthcare Provider Details

I. General information

NPI: 1811191471
Provider Name (Legal Business Name): SARASWATHI DOPATHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S 1ST ST
TEMPLE TX
76504-7451
US

IV. Provider business mailing address

2663 SALORN WAY
ROUND ROCK TX
78681-2382
US

V. Phone/Fax

Practice location:
  • Phone: 254-743-1625
  • Fax: 254-743-0135
Mailing address:
  • Phone: 512-672-9743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN0738
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: