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Organization
AJIT DAVE', M.D., P.A.
Active
Organization
AJIT DAVE', M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE J TIBEDEAU (OFFICE MANAGER)
(940) 382-4060
Entity
Organization
Contact information
Practice address
3327 COLORADO BLVD, SUITE #200, DENTON, TX 76210-6865
(940) 382-4060
(940) 380-9282
Mailing address
3327 COLORADO BLVD, SUITE #200, DENTON, TX 76210-6865
(940) 382-4060
(940) 380-9282
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G8687
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020EC
BCBS
TX
05
—
314890001
—
TX
01
—
D56860
RR MEDICARE PTAN
TX
01
—
TXB143454
MEDICARE PTAN
TX
Enumeration date
05/30/2007
Last updated
06/05/2013
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