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General NPI Number Information
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NPI Number | 1881860484
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Entity Type | Individual
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Provider Name | VIJAYA M DASARI MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 2701 SHORELINE DR 101
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-898-7488
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Fax | 940-247-3006
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Provider Business Mailing Address
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Address Line | 3304 COLORADO BLVD STE 205
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City | DENTON
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State | TX
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Zip | 76210-6877
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Country | US
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Telephone | 940-898-7488
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Fax | 940-243-3554
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | N1604
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License Number State | TX
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