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NPI Code Detail

MEDICARE: DR. SUBRATA KRISHNA TALUKDAR MD

MEDICARE: DR. SUBRATA KRISHNA TALUKDAR MD
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
1207RC0000XCardiovascular Disease PhysicianL9047TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P01076448OTHERTXRAILROAD MEDICARE
4TXB142173OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28DB260OTHERTXBCBS OF TX

General Provider Information

NPI Number : 1437149630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUBRATA KRISHNA TALUKDAR MD
Provider Business Mailing Address
First Line : 4411 MEDICAL DR STE 300
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3824
Country : US
Telephone Number : 210-614-5400
Fax Number : 210-614-2413
Provider Business Practice Location Address
First Line : 12446 WEST AVE STE 200
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78216-2530
Country : US
Telephone Number : 210-386-5400
Fax Number : 210-525-1669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 05/20/2022

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