Organization
INTERNAL MEDICINE ASSOCIATES OF SOUTH DALLAS PA
Active
Organization
INTERNAL MEDICINE ASSOCIATES OF SOUTH DALLAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHWANI DAYAL SRIVASTAVA MD (PRESIDENT)
(214) 697-7985
Entity
Organization
Contact information
Practice address
4305 W WHEATLAND RD, SUITE NUMBER 101, DALLAS, TX 75237-3303
(214) 697-7985
(972) 708-9498
Mailing address
4305 W WHEATLAND RD, SUITE NUMBER 101, DALLAS, TX 75237-3303
(214) 697-7985
(972) 708-9498
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L3488
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0047QW
BCBS
TX
01
—
1467507038
INDIVIDUAL NPI NUMBER
—
05
—
150972102
—
TX
05
—
191673601
—
TX
Enumeration date
10/02/2007
Last updated
10/28/2014
Update your record
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