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General NPI Number Information
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NPI Number | 1295849834
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Entity Type | Individual
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Provider Name | SUJATA BHUSHAN MD
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 4500 S LANCASTER RD BLDG 2,3RD FLOOR,ROOM B333
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 214-857-1588
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 S LANCASTER RD
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 214-857-1588
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Fax | 214-857-1575
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD 38426
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M7861
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License Number State | TX
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