MEDICARE: DIPAN DAS 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
1	208200000X	Plastic Surgery Physician	46805-20	WI
2	208200000X	Plastic Surgery Physician	P2629	TX
3	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	46805-20	WI
4	208600000X	Surgery Physician	46805-020	WI
5	208600000X	Surgery Physician	P2629	TX
6	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	P2629	TX

General Provider Information

NPI Number	:	1730261819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIPAN DAS MD

Provider Business Mailing Address
First Line	:	464 PARK GROVE DR STE A
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1571
Country	:	US
Telephone Number	:	832-232-4263
Fax Number	:

Provider Business Practice Location Address
First Line	:	464 PARK GROVE DR STE A
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1571
Country	:	US
Telephone Number	:	832-232-4263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	01/15/2025

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