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General NPI Number Information
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NPI Number | 1942285671
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Entity Type | Individual
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Provider Name | KANTI L AGRAWAL MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 530 CLARA BARTON BLVD STE 150
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City | GARLAND
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State | TX
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Zip | 75042-5752
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Country | US
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Telephone | 972-487-1117
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Fax | 972-494-2082
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Provider Business Mailing Address
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Address Line | 530 CLARA BARTON BLVD STE 150
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City | GARLAND
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State | TX
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Zip | 75042-5752
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Country | US
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Telephone | 972-487-1117
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Fax | 972-494-2082
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | F8388
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License Number State | TX
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