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General NPI Number Information
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NPI Number | 1407275712
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL NEPHROLOGY CONSULTING LLC
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 6549 COPPERFIELD LN
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City | PLANO
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State | TX
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Zip | 75023-3464
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Country | US
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Telephone | 214-736-7969
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Fax |
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Provider Business Mailing Address
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Address Line | 6549 COPPERFIELD LN
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City | PLANO
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State | TX
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Zip | 75023-3464
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Country | US
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Telephone | 214-736-7969
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MR. VISHAL BAGCHI
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Credential | R.D, L.D
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Telephone | 214-736-7969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | DT80358
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License Number State | TX
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