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NPI Code Detail

MEDICARE: DR. AMOLA S BAGRI M.D.

MEDICARE: DR. AMOLA S BAGRI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology PhysicianL6274TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1L6274OTHERTXMEDICAL LICENSE

General Provider Information

NPI Number : 1265410849
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMOLA S BAGRI M.D.
Provider Business Mailing Address
First Line : 1505 LBJ FWY STE 700
Second Line :
City : DALLAS
State : TX
Zip : 75234-6065
Country : US
Telephone Number : 214-358-2300
Fax Number : 214-579-6941
Provider Business Practice Location Address
First Line : 4701 OLD SHEPARD PL STE 100
Second Line :
City : PLANO
State : TX
Zip : 75093-5295
Country : US
Telephone Number : 214-358-2300
Fax Number : 214-579-6941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 05/09/2024

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Directions to “ DR. AMOLA S BAGRI M.D.” Practice Location

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