Individual
PRAKASH GAJERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
627 TURTLE CREEK DR, TYLER, TX 75701-1832
(817) 321-0404
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
R9959
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
R9959
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Enumeration date
03/21/2017
Last updated
09/10/2024
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