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General NPI Number Information
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NPI Number | 1700375433
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Entity Type | Organization
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Legal Business Name | SUPRIYA AILNANI PLLC
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 2000 MEDICAL DR
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City | LAKEWAY
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State | TX
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Zip | 78734-4200
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Country | US
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Telephone | 817-284-9850
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Fax |
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Provider Business Mailing Address
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Address Line | 6707 BRENTWOOD STAIR RD STE 600
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City | FORT WORTH
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State | TX
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Zip | 76112-3368
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Country | US
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Telephone | 817-284-9850
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Fax | 817-234-3425
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUPRIYA AILNANI
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Credential | MD
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Telephone | 512-221-8173
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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 |
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License Number State |
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