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General NPI Number Information
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NPI Number | 1295090710
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Entity Type | Organization
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Legal Business Name | JAGWANI DERMATOLOGY
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 9301 N CENTRAL EXPY STE 180
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City | DALLAS
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State | TX
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Zip | 75231-0821
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Country | US
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Telephone | 314-374-3614
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Fax |
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Provider Business Mailing Address
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Address Line | 9301 N CENTRAL EXPY STE 180
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City | DALLAS
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State | TX
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Zip | 75231-0821
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Country | US
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Telephone | 314-374-3614
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SONYA JAGWANI
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Credential | M.D.
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Telephone | 314-374-3614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | TX
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